| Forensic Fsp (itt) - Desert Op | |
|
68615 Perez Rd Ste 6a Cathedral City CA 92234-7200 | |
| (951) 955-1625 | |
| Not Available |
| Full Name | Forensic Fsp (itt) - Desert Op |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 68615 Perez Rd Ste 6a, Cathedral City, California |
| Authorized Official Name and Position | Matthew Chang (DIRECTOR RUHS - BEHAVIORAL HEALTH) |
| Authorized Official Contact | 9513584500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Forensic Fsp (itt) - Desert Op 4095 County Circle Dr Riverside CA 92503-3410 Ph: (951) 358-6900 | Forensic Fsp (itt) - Desert Op 68615 Perez Rd Ste 6a Cathedral City CA 92234-7200 Ph: (951) 955-1625 |
| NPI Number | 1528423167 |
|---|---|
| Provider Enumeration Date | 12/28/2015 |
| Last Update Date | 09/09/2022 |
| Certification Date | 09/09/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528423167 | NPI | - | NPPES |
| 00033 | Other | CA | LEGAL ENTITY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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