Organization Name: | DESERT PATH |
NPI Number: | 1649676040 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LINDA CATHCART (CEO) |
Mailing Address: | 12170 E Cornville Rd Cornville |
State: | AZ US |
Postal Code: | 863255260 |
Phone Number: | 9283014596 |
Fax Number: | 9287089620 |
NPI Enumeration Date: | 11/12/2014 |
NPI Last Update Date: | 11/12/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |