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	NV20121553209	NV

General Provider Information

NPI Number	:	1093164279
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTHWEST HEALTHCARE SOLUTIONS, LLC

Provider Business Mailing Address
First Line	:	245 E CENTENNIAL PKWY APT 2039
Second Line	:
City	:	N LAS VEGAS
State	:	NV
Zip	:	89084-1368
Country	:	US
Telephone Number	:	619-200-1519
Fax Number	:

Provider Business Practice Location Address
First Line	:	245 E CENTENNIAL PKWY APT 2039
Second Line	:
City	:	N LAS VEGAS
State	:	NV
Zip	:	89084-1368
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	:	06/08/2016
Last Update Date	:	06/08/2016

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