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General NPI Number Information
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NPI Number | 1932348240
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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 | 02/10/2009
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Last Update Date | 02/26/2009
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Provider Practice Location Address
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Address Line | 1545 W BROADWAY AVE SUITE 1 & 2
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City | APACHE JUNCTION
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State | AZ
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Zip | 85220-7658
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Country | US
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Telephone | 480-671-3032
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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 | MR. JEFF JORDE
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Credential |
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Telephone | 602-285-4285
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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-3172
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License Number State | AZ
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