Healthcare Provider Details

I. General information

NPI: 1194158642
Provider Name (Legal Business Name): SWSENIOR CARESOLUTIONS OFDALLAS,LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2013
Last Update Date: 09/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2321 S BELT LINE RD STE 140
GRAND PRAIRIE TX
75051-4182
US

IV. Provider business mailing address

2321 S BELT LINE RD STE 140
GRAND PRAIRIE TX
75051-4182
US

V. Phone/Fax

Practice location:
  • Phone: 214-412-2588
  • Fax: 214-412-2646
Mailing address:
  • Phone: 214-412-2588
  • Fax: 214-412-2646

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. SUZANNE F MOORE
Title or Position: ADMINISTRATOR /OWNER
Credential:
Phone: 214-412-2588