Provider Demographics
NPI:1356187678
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:BETH
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:
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 1:2311 W ROYAL PALM RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85021-4924
Practice Address - Country:US
Practice Address - Phone:602-269-5300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOUTHWEST NETWORK
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-07-05
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty