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NPI Code Detail

MEDICARE: SOUTHWEST BEHAVIORAL HEALTH SERVICES INC

MEDICARE: SOUTHWEST BEHAVIORAL HEALTH SERVICES INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QP2300XPrimary Care Clinic/Center
2251S00000XCommunity/Behavioral Health Agency

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1144384389
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOUTHWEST BEHAVIORAL HEALTH SERVICES INC
Provider Business Mailing Address
First Line : 3450 N 3RD ST
Second Line :
City : PHOENIX
State : AZ
Zip : 85012-2331
Country : US
Telephone Number : 602-257-9339
Fax Number : 602-265-8574
Provider Business Practice Location Address
First Line : 3450 N 3RD ST
Second Line :
City : PHOENIX
State : AZ
Zip : 85012-2331
Country : US
Telephone Number : 602-265-8338
Fax Number : 602-266-9025
Authorized Official
Title or Position : PRESIDENT AND CEO
Name : MR. JEFF JORDE
Credential :
Telephone Number : 602-257-9339
Provider Enumeration Date : 12/21/2006
Last Update Date : 05/02/2024

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Directions to “SOUTHWEST BEHAVIORAL HEALTH SERVICES INC ” Practice Location

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