Provider Demographics
NPI:1205980927
Name:SOUTHWEST BEHAVIORAL CARE, INC.
Entity type:Organization
Organization Name:SOUTHWEST BEHAVIORAL CARE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:GARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-489-0215
Mailing Address - Street 1:306 CHAMBER PLZ
Mailing Address - Street 2:
Mailing Address - City:CHARLEROI
Mailing Address - State:PA
Mailing Address - Zip Code:15022-1607
Mailing Address - Country:US
Mailing Address - Phone:724-489-9100
Mailing Address - Fax:724-483-9375
Practice Address - Street 1:2 EASTGATE AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:MONESSEN
Practice Address - State:PA
Practice Address - Zip Code:15062-1389
Practice Address - Country:US
Practice Address - Phone:724-684-6489
Practice Address - Fax:724-684-7116
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA414780261QM0855X
PA414770261QM0855X
PA444460251S00000X, 261Q00000X, 261QM0850X, 261QM0801X
PA435650261Q00000X, 251S00000X
PA425270261QM0801X
PA414720261QM0855X
PA444540251S00000X
PA435680251S00000X
PA251B00000X, 251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No251B00000XAgenciesCase Management
No251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA435650OtherLICENSE
PA100740114Medicaid