Provider Demographics
NPI:1083297311
Name:DESERT STAR MENTAL HEALTH CORP
Entity Type:Organization
Organization Name:DESERT STAR MENTAL HEALTH CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:YSABEL
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-992-3289
Mailing Address - Street 1:3514 E TROPICANA AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121-7351
Mailing Address - Country:US
Mailing Address - Phone:702-992-3289
Mailing Address - Fax:
Practice Address - Street 1:3514 E TROPICANA AVE STE 2
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-7351
Practice Address - Country:US
Practice Address - Phone:702-992-3289
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-04
Last Update Date:2022-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)