Provider Demographics
NPI:1760353171
Name:DESERT HOPE WELLNESS LLC
Entity type:Organization
Organization Name:DESERT HOPE WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/COACH
Authorized Official - Prefix:
Authorized Official - First Name:DARYL
Authorized Official - Middle Name:
Authorized Official - Last Name:ENSZ
Authorized Official - Suffix:
Authorized Official - Credentials:BSN RN NC-BC
Authorized Official - Phone:701-203-3373
Mailing Address - Street 1:1176 SALT CEDAR DR
Mailing Address - Street 2:
Mailing Address - City:FORT SUMNER
Mailing Address - State:NM
Mailing Address - Zip Code:88119-9413
Mailing Address - Country:US
Mailing Address - Phone:701-203-3373
Mailing Address - Fax:
Practice Address - Street 1:1176 SALT CEDAR DR
Practice Address - Street 2:
Practice Address - City:FORT SUMNER
Practice Address - State:NM
Practice Address - Zip Code:88119-9413
Practice Address - Country:US
Practice Address - Phone:701-203-3373
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-17
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center