Provider Demographics
NPI:1750736724
Name:DESERT SAGE BEHAVIORAL HEALTH, PLC
Entity type:Organization
Organization Name:DESERT SAGE BEHAVIORAL HEALTH, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAFETZ
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:866-213-0445
Mailing Address - Street 1:7090 N ORACLE RD
Mailing Address - Street 2:SUITE 178-203
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-4333
Mailing Address - Country:US
Mailing Address - Phone:866-213-0445
Mailing Address - Fax:866-531-9559
Practice Address - Street 1:7090 N ORACLE RD
Practice Address - Street 2:SUITE 178-203
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-4333
Practice Address - Country:US
Practice Address - Phone:866-213-0445
Practice Address - Fax:866-531-9559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-27
Last Update Date:2016-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN103631163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental HealthGroup - Multi-Specialty