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General NPI Number Information
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NPI Number | 1184618985
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Entity Type | Organization
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Legal Business Name | SOUTHWEST CARE ASSOCIATES LP
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Dates
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Enumeration Date | 09/07/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3120 SMITH ST
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City | TEXARKANA
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State | TX
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Zip | 75501-4083
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Country | US
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Telephone | 903-832-8644
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Fax | 903-838-5982
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Provider Business Mailing Address
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Address Line | PO BOX 12322
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City | KNOXVILLE
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State | TN
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Zip | 37912-0322
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Country | US
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Telephone | 865-938-4101
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Fax | 865-938-7230
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Authorized Official
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Title or Position | SEC'Y/TREAS UFM INC-GEN PTR
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Name | DELORES SMITH
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Credential |
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Telephone | 865-938-4101
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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 | 112042
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License Number State | TX
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