Provider Demographics
NPI:1720258577
Name:SOUTHWEST BEHAVIORAL HEALTH SERVICES, INC
Entity Type:Organization
Organization Name:SOUTHWEST BEHAVIORAL HEALTH SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:JORDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-285-8338
Mailing Address - Street 1:3450 N 3RD ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-2331
Mailing Address - Country:US
Mailing Address - Phone:602-285-8338
Mailing Address - Fax:602-265-8574
Practice Address - Street 1:4160 N 108TH AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85037-5468
Practice Address - Country:US
Practice Address - Phone:602-273-2300
Practice Address - Fax:602-225-0361
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-07
Last Update Date:2008-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)