Provider Demographics
NPI:1386066181
Name:DESERT VISTA COUNSELING SERVICES
Entity type:Organization
Organization Name:DESERT VISTA COUNSELING SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:MARTINEAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-201-1427
Mailing Address - Street 1:7565 E EAGLE CREST DR STE 201
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85207-1067
Mailing Address - Country:US
Mailing Address - Phone:480-788-5069
Mailing Address - Fax:
Practice Address - Street 1:7565 E EAGLE CREST DR STE 201
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85207-1067
Practice Address - Country:US
Practice Address - Phone:480-788-5069
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-13
Last Update Date:2024-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty