Provider Demographics
NPI:1053601922
Name:SOUTHWESTERN UNIVERSITY AND GLOBAL COLLEGE
Entity type:Organization
Organization Name:SOUTHWESTERN UNIVERSITY AND GLOBAL COLLEGE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:S
Authorized Official - Last Name:GITTINGS
Authorized Official - Suffix:
Authorized Official - Credentials:PH D
Authorized Official - Phone:520-400-0987
Mailing Address - Street 1:PO BOX 40332
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85717-0332
Mailing Address - Country:US
Mailing Address - Phone:520-429-0493
Mailing Address - Fax:520-203-8227
Practice Address - Street 1:16851 WEST HINCKLEY RD.
Practice Address - Street 2:
Practice Address - City:ARIVACA
Practice Address - State:AZ
Practice Address - Zip Code:85601
Practice Address - Country:US
Practice Address - Phone:520-429-0493
Practice Address - Fax:520-203-8227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-13
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ06260320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities