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General NPI Number Information
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NPI Number | 1487981338
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Entity Type | Organization
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Legal Business Name | SOUTHWEST NETWORK, INC.
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Dates
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Enumeration Date | 11/13/2009
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Last Update Date | 02/18/2025
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Provider Practice Location Address
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Address Line | 1465 W CHANDLER BLVD BLDG A
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City | CHANDLER
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State | AZ
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Zip | 85224-6237
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Country | US
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Telephone | 480-786-8200
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Fax | 480-857-3005
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Provider Business Mailing Address
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Address Line | 2700 N CENTRAL AVE SUITE 1050
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City | PHOENIX
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State | AZ
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Zip | 85004-1133
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Country | US
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Telephone | 602-266-8402
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Fax | 602-264-0887
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MS. AMY B. HENNING
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Credential |
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Telephone | 602-285-4340
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | OTC6322
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | OTC6322
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License Number State | AZ
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