Healthcare Provider Details

I. General information

NPI: 1144079575
Provider Name (Legal Business Name): DESERT SKY MENTAL HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2024
Last Update Date: 05/23/2024
Certification Date: 05/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

541 N COLEMAN ST
TOOELE UT
84074-1442
US

IV. Provider business mailing address

3556 S 5600 W # 1-596
SALT LAKE CITY UT
84120-2815
US

V. Phone/Fax

Practice location:
  • Phone: 801-406-7526
  • Fax: 801-876-4212
Mailing address:
  • Phone: 801-719-1364
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. BRITTANY TALBOT
Title or Position: OWNER/NURSE PRACTITIONER
Credential: APRN
Phone: 801-719-1364