MEDICARE: SOUTHWEST SENIOR CARE, INC.

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	:	1629271531
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTHWEST SENIOR CARE, INC.

Provider Business Mailing Address
First Line	:	1850 PIPESTONE RD
Second Line	:	SUITE 201B
City	:	BENTON HARBOR
State	:	MI
Zip	:	49022-2304
Country	:	US
Telephone Number	:	269-926-8411
Fax Number	:	269-926-8701

Provider Business Practice Location Address
First Line	:	1850 PIPESTONE RD
Second Line	:	SUITE 201B
City	:	BENTON HARBOR
State	:	MI
Zip	:	49022-2304
Country	:	US
Telephone Number	:	269-926-8411
Fax Number	:	269-926-8701

Authorized Official
Title or Position	:	PRESIDENT
Name	:	REHANA S. MANSOOR BHATTI
Credential	:
Telephone Number	:	269-936-8411

Provider Enumeration Date	:	06/07/2007
Last Update Date	:	08/22/2020

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