| Mh Dentention - John Benoit Detention Center | |
|
82675 Us Highway 111 Indio CA 92201-5635 | |
| (760) 863-8037 | |
| Not Available |
| Full Name | Mh Dentention - John Benoit Detention Center |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 82675 Us Highway 111, Indio, 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 |
|---|---|
| Mh Dentention - John Benoit Detention Center 4095 County Circle Dr Riverside CA 92503-3410 Ph: (951) 358-6900 | Mh Dentention - John Benoit Detention Center 82675 Us Highway 111 Indio CA 92201-5635 Ph: (760) 863-8037 |
| NPI Number | 1235768110 |
|---|---|
| Provider Enumeration Date | 04/03/2020 |
| Last Update Date | 10/12/2022 |
| Certification Date | 10/12/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235768110 | NPI | - | NPPES |
| 3334 | Other | CA | STATE PROVIDER |
| 00033 | Other | CA | LEGAL ENTITY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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