1538594478 NPI number — SOUTHWEST BEHAVIORAL CARE, INC.

Table of content: (NPI 1538594478)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538594478 NPI number — SOUTHWEST BEHAVIORAL CARE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SOUTHWEST BEHAVIORAL CARE, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
SPHS SOUTHWEST BEHAVIORAL HEALTH, INC.
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1538594478
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/23/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
203 S MAPLE AVE FL 2
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GREENSBURG
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15601-3216
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-834-0420
Provider Business Mailing Address Fax Number:
724-853-7613

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
84 N GALLATIN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
UNIONTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15401-3009
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-430-9710
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/11/2013

Additional Information

Authorized Official

Authorized Official Last Name:
GARRETT
Authorized Official First Name:
CHRIS
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
724-489-0215

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , with the licence number:  267019 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1007401140105 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 267019 . This is a "LICENSE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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