Healthcare Provider Details

I. General information

NPI: 1760601207
Provider Name (Legal Business Name): SOUTHWEST BEHAVIORAL CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 02/23/2024
Certification Date: 02/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 GROVE ROAD, JAMISON BLDG TORRANCE STATE HOSPITAL
TORRANCE PA
15779
US

IV. Provider business mailing address

903 E PITTSBURGH ST
GREENSBURG PA
15601-3557
US

V. Phone/Fax

Practice location:
  • Phone: 724-459-0112
  • Fax: 724-459-0686
Mailing address:
  • Phone: 724-853-7550
  • Fax: 724-853-7613

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number657044
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number657051
License Number StatePA

VIII. Authorized Official

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