DESERT STAR BEHAVIORAL HEALTH, LLC (NPI# 1972146496) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972146496 |
| Entity Type | Organization |
| Organization Name | DESERT STAR BEHAVIORAL HEALTH, LLC |
| Practice Address |
650 Ne G Avenue Fabens TX 79838 |
| Practice Telephone | 9153297569 |
| Enumeration Date | 2019-10-28 |
| Last Update Date | 2019-10-28 |
| Authorized Official Name | JOYCE GONZALEZ (MANAGER) |
| Authorized Official Telephone | 9153297569 |
| Authorized Official Credential | LPC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | DESERT STAR BEHAVIORAL HEALTH, LLC | 650 Ne G Ave, Fabens, TX 79838 |
| Street Address |
650 NE G AVENUE |
| City | FABENS |
| State | TX |
| Zip Code | 79838 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063926582 | Steve Anthony Marasovich Sr. | Obstetrics & Gynecology | 591 Fabens Island Road, Fabens, TX 79838 | 2017-11-20 |
| 1194236182 | Us Drug Mart Inc | Pharmacy | 1420 Fabens Rd Ste B, Fabens, TX 79838 | 2017-10-17 |
| 1245772128 | Wallace Watts Jr. | Clinical Nurse Specialist | 101 Potasio Street, Fabens, TX 79838 | 2016-11-09 |
| 1578011078 | Our Family Home Health Care Agency | Home Health | 1268 Twig St, Fabens, TX 79838 | 2016-09-14 |
| 1871910224 | Vanessa Gandarilla | Home Health | 1268 Twig Street, Fabens, TX 79838 | 2014-03-24 |
| 1013272772 | Julia Kviatkovskaya | Nurse Practitioner | 101 Potasio St, Fabens, TX 79838 | 2012-07-09 |
| 1891066692 | Texas Kids Dental Care of Fabens, Pa | Dentist | 1018 N. Fabens, Fabens, TX 79838 | 2012-01-25 |
| 1598053423 | Juan Carlos Israel Hernandez Garcia | Family Medicine | University Medical Center At Fabens, 101 Potasio, Fabens, TX 79838 | 2011-07-12 |
| 1255543724 | Steven L Mosher | Pharmacist | 1420 Fabens Road, Suite B, Fabens, TX 79838 | 2007-05-04 |
| 1306963566 | Project Vida Health Center | Clinic/Center | 101 Potasio, Fabens, TX 79838 | 2007-03-23 |
| Find all providers in zip 79838 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.