1245444942 NPI number — SOUTHWEST BEHAVIORAL CARE, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245444942 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:
Provider Other Organization Name Type Code:
6
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:
1245444942
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/22/2024
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:
2 EASTGATE AVE
Provider Second Line Business Practice Location Address:
SUITE 102
Provider Business Practice Location Address City Name:
MONESSEN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15062-1393
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-684-6489
Provider Business Practice Location Address Fax Number:
724-684-7116
Provider Enumeration Date:
05/10/2007

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:  657023 , 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: 1007401140065 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 657023 . This is a "DEPT. OF HEALTH LICENSE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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