Provider Demographics
NPI:1578665097
Name:DESERT DOVE FARM
Entity Type:Organization
Organization Name:DESERT DOVE FARM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:FAYE
Authorized Official - Middle Name:W
Authorized Official - Last Name:GANDOLFI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-296-0320
Mailing Address - Street 1:PO BOX 31615
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85751-1615
Mailing Address - Country:US
Mailing Address - Phone:520-296-0320
Mailing Address - Fax:
Practice Address - Street 1:3312 N RIVERBEND CIR E
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85750-2571
Practice Address - Country:US
Practice Address - Phone:520-296-0320
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable