Provider Demographics
NPI:1417632746
Name:DESERT AIDS PROJECT
Entity Type:Organization
Organization Name:DESERT AIDS PROJECT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:
Authorized Official - Last Name:STITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-969-4516
Mailing Address - Street 1:1695 N SUNRISE WAY
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-3701
Mailing Address - Country:US
Mailing Address - Phone:760-323-2118
Mailing Address - Fax:
Practice Address - Street 1:58581 US HIGHWAY 371 STE FGH
Practice Address - Street 2:
Practice Address - City:ANZA
Practice Address - State:CA
Practice Address - Zip Code:92539-9331
Practice Address - Country:US
Practice Address - Phone:760-323-2118
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DESERT AIDS PROJECT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-06-15
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)