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General NPI Number Information
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NPI Number | 1508671314
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Entity Type | Organization
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Legal Business Name | DESERT EMPIRE BEHAVIORAL HEALTH, INC.
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Dates
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Enumeration Date | 02/10/2025
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Last Update Date | 02/10/2025
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Provider Practice Location Address
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Address Line | 10323 W OLIVE AVE STE 100
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City | PEORIA
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State | AZ
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Zip | 85345-7345
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Country | US
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Telephone | 602-790-5827
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Fax |
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Provider Business Mailing Address
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Address Line | 10323 W OLIVE AVE STE 100
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City | PEORIA
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State | AZ
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Zip | 85345-7345
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SECRETARY
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Name | SOON BURNAM
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Credential |
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Telephone | 949-540-1249
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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