Provider Demographics
NPI:1760601207
Name:SOUTHWEST BEHAVIORAL CARE, INC.
Entity Type:Organization
Organization Name:SOUTHWEST BEHAVIORAL CARE, INC.
Other - Org Name:SPHS BEHAVIORAL HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:GARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-489-0215
Mailing Address - Street 1:903 E PITTSBURGH ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-3557
Mailing Address - Country:US
Mailing Address - Phone:724-853-7550
Mailing Address - Fax:724-853-7613
Practice Address - Street 1:208 GROVE ROAD, JAMISON BLDG
Practice Address - Street 2:TORRANCE STATE HOSPITAL
Practice Address - City:TORRANCE
Practice Address - State:PA
Practice Address - Zip Code:15779
Practice Address - Country:US
Practice Address - Phone:724-459-0112
Practice Address - Fax:724-459-0686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA657044251B00000X
PA657051251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007401140039Medicaid
PA657044OtherDEPT. OF HEALTH ID