Organization
DESERT SOLACE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK JORGENSEN (CEO)
(435) 817-1351
Entity
Organization
Contact information
Practice address
1239 W 4200 N, ST GEORGE, UT 84770-5982
(435) 817-1351
Mailing address
1173 S 250 W, SUITE 207, ST GEORGE, UT 84770-6392
(435) 817-1351
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
19493
UT
Other
Enumeration date
09/12/2012
Last updated
09/12/2012
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