Provider Demographics
NPI:1396468716
Name:PHAROS POINTE LLC
Entity type:Organization
Organization Name:PHAROS POINTE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHERY
Authorized Official - Middle Name:
Authorized Official - Last Name:BEAUPREZ
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:970-630-1220
Mailing Address - Street 1:PO BOX 28
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:CO
Mailing Address - Zip Code:80759-0028
Mailing Address - Country:US
Mailing Address - Phone:970-630-5863
Mailing Address - Fax:
Practice Address - Street 1:717 S ASH ST
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:CO
Practice Address - Zip Code:80759-2613
Practice Address - Country:US
Practice Address - Phone:970-630-5863
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-21
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health