NPIMap

Organization Active NPI

Southwest Behavioral Health Services, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Prescott Valley, AZ
National Provider Identifier
1578844726
Registry record updated Sep 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
BH-3898 Issued in AZ
Legal business name
SOUTHWEST BEHAVIORAL HEALTH SERVICES, INC.
Practice address
7763 E Florentine Rd
Prescott Valley, AZ 86314-2289
Phone
(928) 717-1800
NPI assigned
Sep 1, 2011
Last updated
Sep 1, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jeff Jorde
Title
President/Ceo
Phone
(602) 257-9339

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X BH-3898 AZ Primary

Addresses

Primary practice location

7763 E Florentine Rd
Prescott Valley, AZ 86314-2289

Mailing address

3450 N 3Rd St
Phoenix, AZ 85012-2331

Other identifiers 1

IdentifierTypeStateIssuer
BH-3898OtherAZARIZONA DEPT OF HEALTH SERVICES, OBHL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040225000948 AZ Part B Supplier - Clinic/Group Practice 9739075854 Receives reassigned benefits from 136 practitioners
24 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Phoenix, AZ; Mesa, AZ; Prescott Valley, AZ; Payson, AZ; Lake Havasu City, AZ; Kingman, AZ; Flagstaff, AZ; Bullhead City, AZ…

Other NPIs on the same Medicare enrollment 24

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 24

National Provider Directory

National Provider Directory

Locations

26428 W US Highway 85
Buckeye, AZ 85326
Phone (623) 251-8507

1515 E Cedar Ave
Ste E12
Flagstaff, AZ 86004

Practitioners & affiliated clinicians

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 21

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1314835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314835200000",
    "number": "1578844726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3450 N 3RD ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7763 E FLORENTINE RD",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863142289",
            "telephone_number": "928-717-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST BEHAVIORAL HEALTH SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-01",
        "last_updated": "2011-09-01",
        "status": "A",
        "authorized_official_last_name": "JORDE",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "602-257-9339"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "AZ",
            "license": "BH-3898",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARIZONA DEPT OF HEALTH SERVICES, OBHL",
            "identifier": "BH-3898",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott Valley, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.