Provider Demographics
NPI:1083887988
Name:SOUTHWEST INTEGRATIVE HEALTH CENTER, LLC
Entity Type:Organization
Organization Name:SOUTHWEST INTEGRATIVE HEALTH CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-256-3648
Mailing Address - Street 1:5310 HOMESTEAD RD NE
Mailing Address - Street 2:BLDG 400
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-1437
Mailing Address - Country:US
Mailing Address - Phone:505-256-3648
Mailing Address - Fax:505-256-9778
Practice Address - Street 1:5310 HOMESTEAD RD NE STE 400
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-1437
Practice Address - Country:US
Practice Address - Phone:505-256-3648
Practice Address - Fax:505-256-9778
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-11
Last Update Date:2011-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty