Provider Demographics
NPI:1891503405
Name:DESERT PATH TO RECOVERY LLC
Entity type:Organization
Organization Name:DESERT PATH TO RECOVERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:TOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-730-2023
Mailing Address - Street 1:7108 N 13TH PL
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-5408
Mailing Address - Country:US
Mailing Address - Phone:520-730-2023
Mailing Address - Fax:
Practice Address - Street 1:7108 N 13TH PL
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-5408
Practice Address - Country:US
Practice Address - Phone:520-730-2023
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-28
Last Update Date:2024-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder