Healthcare Provider Details
I. General information
NPI: 1811483878
Provider Name (Legal Business Name): DESERT MOUNTAIN HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/02/2018
Last Update Date: 07/16/2025
Certification Date: 07/16/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3131 W PEORIA AVE
PHOENIX AZ
85029-5226
US
IV. Provider business mailing address
7500 N DREAMY DRAW DR STE 205
PHOENIX AZ
85020-4669
US
V. Phone/Fax
- Phone: 480-371-0180
- Fax:
- Phone: 480-371-0180
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0802X |
| Taxonomy | Addiction Psychiatry Physician |
| License Number | IFBH9001 |
| License Number State | AZ |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 276400000X |
| Taxonomy | Substance Use Disorder Rehabilitation Hospital Unit |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 324500000X |
| Taxonomy | Substance Abuse Rehabilitation Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
TIM
BESCH
Title or Position: ADMINISTRATOR
Credential:
Phone: 480-371-0180