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General NPI Number Information
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NPI Number | 1053601922
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Entity Type | Organization
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Legal Business Name | SOUTHWESTERN UNIVERSITY AND GLOBAL COLLEGE
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Dates
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Enumeration Date | 04/13/2011
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Last Update Date | 04/13/2011
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Provider Practice Location Address
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Address Line | 16851 WEST HINCKLEY RD.
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City | ARIVACA
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State | AZ
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Zip | 85601
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Country | US
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Telephone | 520-429-0493
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Fax | 520-203-8227
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Provider Business Mailing Address
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Address Line | PO BOX 40332
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City | TUCSON
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State | AZ
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Zip | 85717-0332
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Country | US
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Telephone | 520-429-0493
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Fax | 520-203-8227
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Authorized Official
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Title or Position | CEO
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Name | DR. JAMES S. GITTINGS
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Credential | PH. D.
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Telephone | 520-400-0987
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number | 06260
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License Number State | AZ
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