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NPI Code Detail

MEDICARE: SOUTHWESTERN HEALTH SOLUTION LLC

MEDICARE: SOUTHWESTERN HEALTH SOLUTION 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
1320600000XIntellectual and/or Developmental Disabilities Residential Treatment Facility

General Provider Information

NPI Number : 1528574399
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOUTHWESTERN HEALTH SOLUTION LLC
Provider Business Mailing Address
First Line : 5410 BLUE OAT AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89141-8620
Country : US
Telephone Number : 404-312-2313
Fax Number :
Provider Business Practice Location Address
First Line : 5410 BLUE OAT AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89141-8620
Country : US
Telephone Number : 404-312-2313
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MIGUEL SANCHEZ
Credential :
Telephone Number : 404-312-2313
Provider Enumeration Date : 12/15/2017
Last Update Date : 12/15/2017

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Directions to “SOUTHWESTERN HEALTH SOLUTION LLC ” Practice Location

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