MEDICARE: SOUTHWEST NETWORK, 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

General Provider Information

NPI Number	:	1356187678
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTHWEST NETWORK, INC.

Provider Business Mailing Address
First Line	:	2700 N CENTRAL AVE
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85004-1133
Country	:	US
Telephone Number	:	602-266-8402
Fax Number	:	602-264-0887

Provider Business Practice Location Address
First Line	:	2311 W ROYAL PALM RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85021-4924
Country	:	US
Telephone Number	:	602-269-5300
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	AMY BETH HENNING
Credential	:
Telephone Number	:	602-285-4340

Provider Enumeration Date	:	07/05/2024
Last Update Date	:	02/18/2025

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Directions to “SOUTHWEST NETWORK, INC. ” Practice Location

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