Provider Demographics
NPI:1578866109
Name:SOUTHWEST NETWORK, INC.
Entity Type:Organization
Organization Name:SOUTHWEST NETWORK, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:B
Authorized Official - Last Name:HENNING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-285-4340
Mailing Address - Street 1:2700 N CENTRAL AVE
Mailing Address - Street 2:SUITE 1050
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85004-1133
Mailing Address - Country:US
Mailing Address - Phone:602-266-8402
Mailing Address - Fax:602-264-0887
Practice Address - Street 1:2700 N CENTRAL AVE
Practice Address - Street 2:SUITE 1050
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85004-1133
Practice Address - Country:US
Practice Address - Phone:602-266-8402
Practice Address - Fax:602-264-0887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-21
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health