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General NPI Number Information
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NPI Number | 1487974812
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Entity Type | Organization
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Legal Business Name | SOUTHWEST BEHAVIORAL HEALTH SERVICES, INC.
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Dates
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Enumeration Date | 06/08/2010
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Last Update Date | 06/08/2010
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Provider Practice Location Address
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Address Line | 1700 E DON CARLOS AVE APT 101
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City | TEMPE
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State | AZ
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Zip | 85281-4346
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Country | US
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Telephone | 480-829-6020
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Fax |
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Provider Business Mailing Address
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Address Line | 3450 N 3RD ST
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City | PHOENIX
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State | AZ
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Zip | 85012-2331
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | JEFF JORDE
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Credential |
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Telephone | 602-257-9339
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | BH-3573
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License Number State | AZ
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