Organization
DESERT EDGE MENTORING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DENNIS GREGORY (EXECUTIVE DIRECTOR)
(602) 237-2485
Entity
Organization
Contact information
Practice address
1950 W HEATHERBRAE DR, STE 10, PHOENIX, AZ 85015-5110
(602) 237-2485
(602) 274-6531
Mailing address
PO BOX 1097, LAVEEN, AZ 85339-1097
(602) 237-2485
(602) 274-6531
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
BH-3807
AZ
Other
Enumeration date
12/31/2007
Last updated
01/14/2011
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