Provider Demographics
NPI:1992495865
Name:SOUTHWEST OHIO HOME CARE LLC
Entity type:Organization
Organization Name:SOUTHWEST OHIO HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADON
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:M
Authorized Official - Last Name:DAVENPORT
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:937-913-4314
Mailing Address - Street 1:5624 HECKATHORN RD
Mailing Address - Street 2:
Mailing Address - City:BROOKVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45309-8305
Mailing Address - Country:US
Mailing Address - Phone:937-913-4314
Mailing Address - Fax:937-870-1323
Practice Address - Street 1:5624 HECKATHORN RD
Practice Address - Street 2:
Practice Address - City:BROOKVILLE
Practice Address - State:OH
Practice Address - Zip Code:45309-8305
Practice Address - Country:US
Practice Address - Phone:937-913-4314
Practice Address - Fax:937-870-1323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-12
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health