Healthcare Provider Details

I. General information

NPI: 1255448833
Provider Name (Legal Business Name): SOUTHWEST BEHAVIORAL HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2006
Last Update Date: 11/09/2023
Certification Date: 11/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1424 S 7TH AVE
PHOENIX AZ
85007-3902
US

IV. Provider business mailing address

3450 N 3RD ST
PHOENIX AZ
85012-2331
US

V. Phone/Fax

Practice location:
  • Phone: 602-257-8970
  • Fax: 602-462-5941
Mailing address:
  • Phone: 602-257-9339
  • Fax: 602-265-8574

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License NumberBH-1982
License Number StateAZ

VIII. Authorized Official

Name: STEVEN SHEETS
Title or Position: PRESIDENT / CEO
Credential:
Phone: 602-351-6986