MEDICARE: SOUTHWEST BEHAVIORAL CARE, 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
1	251S00000X	Community/Behavioral Health Agency	657023	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	657023	OTHER	PA	DEPT. OF HEALTH LICENSE

General Provider Information

NPI Number	:	1245444942
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTHWEST BEHAVIORAL CARE, INC.

Provider Business Mailing Address
First Line	:	203 S MAPLE AVE FL 2
Second Line	:
City	:	GREENSBURG
State	:	PA
Zip	:	15601-3216
Country	:	US
Telephone Number	:	724-834-0420
Fax Number	:	724-853-7613

Provider Business Practice Location Address
First Line	:	2 EASTGATE AVE
Second Line	:	SUITE 102
City	:	MONESSEN
State	:	PA
Zip	:	15062-1393
Country	:	US
Telephone Number	:	724-684-6489
Fax Number	:	724-684-7116

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	CHRIS GARRETT
Credential	:	MSW, LSW
Telephone Number	:	724-489-0215

Provider Enumeration Date	:	05/10/2007
Last Update Date	:	02/22/2024

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