Organization
SOUTHWEST COUNSELING SERVICES LLC
Active
Organization
SOUTHWEST COUNSELING SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDALL R HANSEN M.ED., LISAC (CHIEF EXECUTIVE OFFICER)
(928) 446-8278
Entity
Organization
Contact information
Practice address
281 W 24TH ST, STE 134, YUMA, AZ 85364-8500
(928) 446-8278
Mailing address
281 W 24TH ST, STE 134, YUMA, AZ 85364-8500
(928) 446-8278
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
LISAC-11869
AZ
Other
Enumeration date
12/23/2009
Last updated
04/21/2010
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