MEDICARE: DESERT BEHAVIORAL HEALTH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency	1008584355-000	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1467785527
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DESERT BEHAVIORAL HEALTH

Provider Business Mailing Address
First Line	:	4055 SPENCER ST STE 118
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-5250
Country	:	US
Telephone Number	:	702-799-9710
Fax Number	:	702-799-9712

Provider Business Practice Location Address
First Line	:	4055 SPENCER ST STE 118
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-5250
Country	:	US
Telephone Number	:	702-799-9710
Fax Number	:	702-799-9712

Authorized Official
Title or Position	:	CEO/CLINICAL DIRECTOR
Name	:	QINGFANG ZHANG
Credential	:	PHD, LCSW
Telephone Number	:	702-799-9710

Provider Enumeration Date	:	09/08/2009
Last Update Date	:	04/12/2019

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Directions to “DESERT BEHAVIORAL HEALTH ” Practice Location

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