Healthcare Provider Details

I. General information

NPI: 1285688515
Provider Name (Legal Business Name): SOUTHWEST CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 12/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

474 W 200 N
ST GEORGE UT
84770-4505
US

IV. Provider business mailing address

474 W 200 N #300
ST GEORGE UT
84770-4505
US

V. Phone/Fax

Practice location:
  • Phone: 435-634-5600
  • Fax: 435-986-8700
Mailing address:
  • Phone: 435-634-5600
  • Fax: 435-986-8700

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: ART W SAWYER
Title or Position: ACCOUNTS RECEIVABLE COORDINATOR
Credential:
Phone: 435-634-5621