Organization
SOUTHWEST NETWORK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. AMY B. HENNING (CEO)
(602) 285-4351
Entity
Organization
Contact information
Practice address
3140 N ARIZONA AVE, SUITE 113, CHANDLER, AZ 85225-7165
(480) 497-4040
(480) 497-4041
Mailing address
2700 N CENTRAL AVE, SUITE 1050, PHOENIX, AZ 85004-1133
(602) 266-8402
(602) 264-0887
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
OTC6986
AZ
251S00000X
Community/Behavioral Health Agency
Primary
OTC6986
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
393484
—
AZ
01
—
Z127516
MEDICARE PTAN
AZ
Enumeration date
07/18/2008
Last updated
07/03/2025
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