Healthcare Provider Details
I. General information
NPI: 1720582570
Provider Name (Legal Business Name): DESERT TREATMENT CLINIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/19/2018
Last Update Date: 04/02/2025
Certification Date: 04/02/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2598 WINDMILL PKWY STE 100
HENDERSON NV
89074-5476
US
IV. Provider business mailing address
2598 WINDMILL PKWY STE 100
HENDERSON NV
89074-5476
US
V. Phone/Fax
- Phone: 702-248-0000
- Fax: 702-992-9954
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
NGANHA
CHEUNG
Title or Position: PRESIDENT
Credential:
Phone: 702-222-7777