Provider Demographics
NPI:1649954660
Name:DESERT SANDS MENTAL HEALTH LLC
Entity type:Organization
Organization Name:DESERT SANDS MENTAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ORAVEC
Authorized Official - Suffix:
Authorized Official - Credentials:PNHNP-BC, CNP
Authorized Official - Phone:575-649-1865
Mailing Address - Street 1:2439 SAGUARO LOOP
Mailing Address - Street 2:
Mailing Address - City:ALAMOGORDO
Mailing Address - State:NM
Mailing Address - Zip Code:88310-7868
Mailing Address - Country:US
Mailing Address - Phone:575-649-1865
Mailing Address - Fax:
Practice Address - Street 1:2439 SAGUARO LOOP
Practice Address - Street 2:
Practice Address - City:ALAMOGORDO
Practice Address - State:NM
Practice Address - Zip Code:88310-7868
Practice Address - Country:US
Practice Address - Phone:575-649-1865
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-12
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health