| New Life Su - Indio Probation | |
|
47940 Arabia St Indio CA 92201-6828 | |
| (951) 955-1503 | |
| Not Available |
| Full Name | New Life Su - Indio Probation |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 47940 Arabia St, Indio, California |
| Authorized Official Name and Position | Jerry Wengerd (DIRECTOR OF MENTAL HEALTH) |
| Authorized Official Contact | 9513584500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| New Life Su - Indio Probation 4095 County Circle Dr Riverside CA 92503-3410 Ph: (951) 358-6900 | New Life Su - Indio Probation 47940 Arabia St Indio CA 92201-6828 Ph: (951) 955-1503 |
| NPI Number | 1417320060 |
|---|---|
| Provider Enumeration Date | 11/04/2015 |
| Last Update Date | 11/04/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417320060 | NPI | - | NPPES |
| 00033 | Other | CA | LEGAL ENTITY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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