Provider Demographics
NPI:1831851146
Name:SOUTHWEST HEALTHCARE SERVICES
Entity type:Organization
Organization Name:SOUTHWEST HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TINA
Authorized Official - Middle Name:M
Authorized Official - Last Name:MARMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-523-7150
Mailing Address - Street 1:802 2ND ST NW
Mailing Address - Street 2:
Mailing Address - City:BOWMAN
Mailing Address - State:ND
Mailing Address - Zip Code:58623-4483
Mailing Address - Country:US
Mailing Address - Phone:701-523-5555
Mailing Address - Fax:
Practice Address - Street 1:802 2ND ST NW
Practice Address - Street 2:
Practice Address - City:BOWMAN
Practice Address - State:ND
Practice Address - Zip Code:58623-4483
Practice Address - Country:US
Practice Address - Phone:701-523-5555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOUTHWEST HEALTHCARE SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-10-13
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility