417 Desert Cities, LLC
Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children in Palm Desert, CA. Organization (NPI-2).
NPI number1750817383
StatusActive
Last updated in NPPESDec 6, 2023
Details
- NPI
- 1750817383
- Entity type
- Organization (NPI-2)
- Legal business name
- 417 Desert Cities, LLC
- Organization subpart
- No
- Enumeration date
- May 2, 2017
- Certification date
- Dec 6, 2023
- Last updated
- Dec 6, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3245S0500X | Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children | – | – | Yes |
| 251S00000X | Community/Behavioral Health | – | – | |
| 261QM0855X | Clinic/Center, Adolescent and Children Mental Health | – | – |
Other names
- 417 Recovery (Doing Business As)
Practice location
74075 El Paseo Ste A5Palm Desert, CA 92260-4118
Phone 760-565-2998 · Fax 442-282-1100
Mailing address
74075 El Paseo Ste A5Palm Desert, CA 92260-4118
Phone 760-565-2998 · Fax 442-282-1100
Authorized official
Stevie Kuhn
Owner/Partner
7605652998
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