Provider Demographics
NPI:1194158642
Name:SWSENIOR CARESOLUTIONS OFDALLAS,LLC.
Entity type:Organization
Organization Name:SWSENIOR CARESOLUTIONS OFDALLAS,LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR /OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:F
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-412-2588
Mailing Address - Street 1:2321 S BELT LINE RD STE 140
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75051-4182
Mailing Address - Country:US
Mailing Address - Phone:214-412-2588
Mailing Address - Fax:214-412-2646
Practice Address - Street 1:2321 S BELT LINE RD STE 140
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75051-4182
Practice Address - Country:US
Practice Address - Phone:214-412-2588
Practice Address - Fax:214-412-2646
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-19
Last Update Date:2013-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health