Healthcare Provider Details

I. General information

NPI: 1679409197
Provider Name (Legal Business Name): DESERT BLOOM BEHAVIOR SUPPORT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8376 E 26TH ST
YUMA AZ
85365-5806
US

IV. Provider business mailing address

8376 E 26TH ST
YUMA AZ
85365-5806
US

V. Phone/Fax

Practice location:
  • Phone: 928-920-0142
  • Fax:
Mailing address:
  • Phone: 928-920-0142
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: SARA MACKENZIE SCOTT
Title or Position: BCBA
Credential: BCBA, LBA-AZ
Phone: 928-920-0142