Healthcare Provider Details

I. General information

NPI: 1750595450
Provider Name (Legal Business Name): SOUTHWEST BEHAVIORAL CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2007
Last Update Date: 02/23/2024
Certification Date: 02/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1929 DAILEY AVE
LATROBE PA
15650-3087
US

IV. Provider business mailing address

203 S MAPLE AVE LOWER LEVEL
GREENSBURG PA
15601-3216
US

V. Phone/Fax

Practice location:
  • Phone: 724-532-1700
  • Fax: 724-532-2769
Mailing address:
  • Phone: 724-853-7550
  • Fax: 724-853-7613

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number657035
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number657035
License Number StatePA

VIII. Authorized Official

Name: CHRIS GARRETT
Title or Position: EXECUTIVE DIRECTOR
Credential: MSW, LSW
Phone: 724-489-0215