MEDICARE: SOUTHWEST HEALTHCARE SOLUTIONS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1063763555
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTHWEST HEALTHCARE SOLUTIONS, LLC

Provider Business Mailing Address
First Line	:	4040 N TENAYA WAY
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89129-6586
Country	:	US
Telephone Number	:	619-200-1519
Fax Number	:

Provider Business Practice Location Address
First Line	:	4040 N TENAYA WAY
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89129-6586
Country	:	US
Telephone Number	:	619-200-1519
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER, ADMINISTRATOR
Name	:	DEANN WILLIAMS
Credential	:
Telephone Number	:	619-200-1519

Provider Enumeration Date	:	09/25/2012
Last Update Date	:	09/07/2013

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