Provider Demographics
NPI:1649035528
Name:DESERT CARE HOMES
Entity type:Organization
Organization Name:DESERT CARE HOMES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:309-287-6041
Mailing Address - Street 1:7225 SOUTHERN MAGNOLIA ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89149-1967
Mailing Address - Country:US
Mailing Address - Phone:309-287-6041
Mailing Address - Fax:
Practice Address - Street 1:7225 SOUTHERN MAGNOLIA ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89149-1967
Practice Address - Country:US
Practice Address - Phone:309-287-6041
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-19
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities
No174200000XOther Service ProvidersMeals
No177F00000XOther Service ProvidersLodging
No311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No385H00000XRespite Care FacilityRespite Care