| Mental Health Substance Abuse Program | |
|
83912 Avenue 45 Ste 9 Indio CA 92201-3338 | |
| (760) 347-0754 | |
| (760) 347-8507 |
| Full Name | Mental Health Substance Abuse Program |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 83912 Avenue 45 Ste 9, Indio, California |
| Authorized Official Name and Position | Maryjo Loera (BEHAVIORAL HEALTH SPECIALIST III) |
| Authorized Official Contact | 7603470754 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mental Health Substance Abuse Program 83912 Avenue 45 Ste 9 Indio CA 92201-3338 Ph: (760) 347-0754 | Mental Health Substance Abuse Program 83912 Avenue 45 Ste 9 Indio CA 92201-3338 Ph: (760) 347-0754 |
| NPI Number | 1568604452 |
|---|---|
| Provider Enumeration Date | 03/24/2009 |
| Last Update Date | 03/24/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568604452 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | RW2331 (California) | Primary |
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