Provider Demographics
NPI:1013149970
Name:DESERT STAR ARC
Entity Type:Organization
Organization Name:DESERT STAR ARC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:POPPY
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LISAC
Authorized Official - Phone:520-490-4049
Mailing Address - Street 1:7493 N ORACLE RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-6343
Mailing Address - Country:US
Mailing Address - Phone:520-638-6000
Mailing Address - Fax:520-395-2489
Practice Address - Street 1:7493 N ORACLE RD
Practice Address - Street 2:SUITE 203
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-6343
Practice Address - Country:US
Practice Address - Phone:520-638-6000
Practice Address - Fax:520-395-2489
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-11
Last Update Date:2009-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health