Provider Demographics
NPI:1205627049
Name:BEHAVIORAL HEALTH SOUTHWEST
Entity type:Organization
Organization Name:BEHAVIORAL HEALTH SOUTHWEST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCGRATH WETJEN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:563-500-9446
Mailing Address - Street 1:6689 BOULDER BROOK CT STE 4
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52003-9762
Mailing Address - Country:US
Mailing Address - Phone:563-500-9446
Mailing Address - Fax:
Practice Address - Street 1:6689 BOULDER BROOK CT STE 4
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52003-9762
Practice Address - Country:US
Practice Address - Phone:563-500-9446
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-13
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)