| High Desert Juvenile Detention And Assessment Center | |
|
21101 Dale Evans Pkwy Apple Valley CA 92307-9356 | |
| (760) 961-6718 | |
| (760) 961-6717 |
| Full Name | High Desert Juvenile Detention And Assessment Center |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 21101 Dale Evans Pkwy, Apple Valley, California |
| Authorized Official Name and Position | Raylene Robinson (CLINICAL SUPERVISOR) |
| Authorized Official Contact | 7609617613 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| High Desert Juvenile Detention And Assessment Center 21101 Dale Evans Pkwy Apple Valley CA 92307-9356 Ph: (760) 961-6718 | High Desert Juvenile Detention And Assessment Center 21101 Dale Evans Pkwy Apple Valley CA 92307-9356 Ph: (760) 961-6718 |
| NPI Number | 1588795975 |
|---|---|
| Provider Enumeration Date | 03/08/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588795975 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | IMF 47669 (California) | Primary |
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High Desert Juvenile Detention And Assessment Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 21101 Dale Evans Pkwy, Apple Valley, CA 92307 Phone: 760-961-6767 Fax: 760-961-6717 |