Banyan Palm Springs LLC
Substance Abuse Rehabilitation Facility in Palm Desert, CA. Organization (NPI-2).
NPI number1912540766
StatusActive
Last updated in NPPESMay 13, 2025
Details
- NPI
- 1912540766
- Entity type
- Organization (NPI-2)
- Legal business name
- Banyan Palm Springs LLC
- Organization subpart
- No
- Enumeration date
- Oct 24, 2019
- Certification date
- May 13, 2025
- Last updated
- May 13, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 324500000X | Substance Abuse Rehabilitation Facility | – | – | Yes |
Other names
- Banyan Palm Springs Outpatient (Doing Business As)
Practice location
73771 Dinah Shore DrPalm Desert, CA 92211-0860
Phone 760-616-5800 · Fax 760-673-7443
Mailing address
225 N Federal HwyPompano Beach, FL 33062-4319
Phone 303-381-8341 · Fax 954-781-7173
Authorized official
John Sory
Ceo
9545337705
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