Healthcare Provider Details

I. General information

NPI: 1871934877
Provider Name (Legal Business Name): DESERT PARKWAY BEHAVIORAL HEALTHCARE HOSPITAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2013
Last Update Date: 08/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3247 S MARYLAND PKWY
LAS VEGAS NV
89109-2412
US

IV. Provider business mailing address

3247 S MARYLAND PKWY
LAS VEGAS NV
89109-2412
US

V. Phone/Fax

Practice location:
  • Phone: 702-776-3500
  • Fax: 702-776-3511
Mailing address:
  • Phone: 702-776-3500
  • Fax: 702-776-3511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number
License Number State

VIII. Authorized Official

Name: LAURA SANDERS
Title or Position: SVP/ GENERAL COUNSEL
Credential:
Phone: 248-905-5091