Provider Demographics
NPI:1811657091
Name:DESERT CACTUS HOMES LLC
Entity type:Organization
Organization Name:DESERT CACTUS HOMES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:FELS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-366-4948
Mailing Address - Street 1:173 TERRACE AVE
Mailing Address - Street 2:
Mailing Address - City:ELMONT
Mailing Address - State:NY
Mailing Address - Zip Code:11003-1739
Mailing Address - Country:US
Mailing Address - Phone:516-314-6315
Mailing Address - Fax:
Practice Address - Street 1:461 N YUCCA CIR
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85201-4551
Practice Address - Country:US
Practice Address - Phone:480-366-4948
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-29
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities