Organization · NPI-2

Coachella Valley Treatment Center

Psychologist, Counseling · Indio, CA

NPI number1770294159
StatusActive
Last updated in NPPESDec 7, 2022

Details

NPI
1770294159
Entity type
Organization (NPI-2)
Legal business name
Coachella Valley Treatment Center
Organization subpart
No
Enumeration date
Dec 7, 2022
Certification date
Dec 5, 2022
Last updated
Dec 7, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
103TC1900X Psychologist, Counseling––Yes
261Q00000X Clinic/Center––

Other names

  • Coachella Valley Treatment Center (Former Legal Business Name)

Practice location

81709 Dr Carreon Blvd
Indio, CA 92201-5509

Phone 760-347-0000

Mailing address

81709 Dr Carreon Blvd
Indio, CA 92201-5509

Phone 760-347-0000 · Fax 760-347-0020

Authorized official

Dimple Agrawal.
Medical Director
7603470000

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