=====================================================
General NPI Number Information
=====================================================
NPI Number | 1598797334
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SOUTHWEST GENERAL HEALTH CENTER
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/06/2006
-----------------------------------------------------
Last Update Date | 03/14/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7575 OLD OAK BLVD
-----------------------------------------------------
City | MIDDLEBURG HTS
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44130-3344
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 440-816-6850
-----------------------------------------------------
Fax | 440-816-6859
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7575 OLD OAK BLVD
-----------------------------------------------------
City | MIDDLEBURG HTS
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44130-3417
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 440-816-6811
-----------------------------------------------------
Fax | 440-816-6859
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | VP/CFO
-----------------------------------------------------
Name | WILLIAM YOUNG JR.
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 440-816-6701
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------