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77725 Enfield Ln # 100-200 Palm Desert CA 92211 | |
(760) 345-7239 | |
Not Available |
Full Name | |
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Speciality | Clinic/center - Rehabilitation, Substance Use Disorder |
Location | 77725 Enfield Ln # 100-200, Palm Desert, California |
Authorized Official Name and Position | Amy Crichton (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 7602003839 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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77725 Enfield Ln Palm Desert CA 92211-0468 Ph: (760) 409-1287 | 77725 Enfield Ln # 100-200 Palm Desert CA 92211 Ph: (760) 345-7239 |
NPI Number | 1942702055 |
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Provider Enumeration Date | 03/05/2018 |
Last Update Date | 08/07/2018 |
Identifier | Type | State | Issuer |
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1942702055 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QM1300X | Clinic/center - Multi-specialty | 330143BP (California) | Secondary |
261QR0405X | Clinic/center - Rehabilitation, Substance Use Disorder | 330143BP (California) | Primary |
Faculty Physicians And Surgeons Of Llusm Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 41865 Boardwalk, Suite 103, Palm Desert, CA 92211 Phone: 760-341-5570 Fax: 909-558-3905 | |
Jitka Civrna Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 74000 Country Club Dr Ste G2, Palm Desert, CA 92260 Phone: 760-773-4948 Fax: 760-773-4910 | |