Organization
SOUTHWEST IN HOME SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KELLY SCOTT TEGANTVOORT (PRESIDENT & CEO)
(602) 463-1210
Entity
Organization
Contact information
Practice address
16042 N 32ND ST, SUITE B 12, PHOENIX, AZ 85032-3806
(602) 463-1210
Mailing address
16042 N 32ND ST, SUITE B-12, PHOENIX, AZ 85032-3806
(602) 463-1210
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
04/29/2008
Last updated
04/29/2008
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