Organization Name: | SOUTHWEST BEHAVIORAL HEALTH SERVICE |
NPI Number: | 1104030980 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JEFF JORDE (PRESIDENT-CEO) |
Mailing Address: | 26428 West Hwy 85 Buckeye |
State: | AZ US |
Postal Code: | 85326 |
Phone Number: | 6022579339 |
Fax Number: | 6022658574 |
NPI Enumeration Date: | 05/10/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QM0801X |
License Number: | BH-2875 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Mental Health (Including Community Mental Health Center) |
Taxonomy Definition: |