Provider Demographics
NPI:1912109638
Name:SOUTHWEST KEY
Entity Type:Organization
Organization Name:SOUTHWEST KEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS, YOUTH JUST
Authorized Official - Prefix:MS
Authorized Official - First Name:LAYLA
Authorized Official - Middle Name:F
Authorized Official - Last Name:FRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-669-8999
Mailing Address - Street 1:6002 JAIN LN
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78721-3104
Mailing Address - Country:US
Mailing Address - Phone:512-669-8999
Mailing Address - Fax:
Practice Address - Street 1:6002 JAIN LN
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78721-3104
Practice Address - Country:US
Practice Address - Phone:512-669-8999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 251S00000X
AZBH-2548251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251B00000XAgenciesCase Management
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral Health