Provider Demographics
NPI:1972366003
Name:SOUTH WEST HOME CARE
Entity type:Organization
Organization Name:SOUTH WEST HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKINLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-220-2131
Mailing Address - Street 1:2817 PORTAGE ST UNIT 2
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49001-6522
Mailing Address - Country:US
Mailing Address - Phone:269-220-2131
Mailing Address - Fax:
Practice Address - Street 1:2817 PORTAGE ST UNIT 2
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49001-6522
Practice Address - Country:US
Practice Address - Phone:269-220-2131
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-01
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health