05D2160120 CLIA NUMBER - VALLEY STAR CRISIS RESIDENTIAL TREATMENT MORONGO OASIS

Laboratory Demographics

CLIA Number: 05D2160120

Facility Name: VALLEY STAR CRISIS RESIDENTIAL TREATMENT MORONGO OASIS

Facility Address:
60805 29 PALMS HIGHWAY
JOSHUA TREE, CA
ZIP 92252
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Facility Phone Number: 760 974-5990

Facility Type: Other - CRISIS RESIDENTIAL

Certificate Type: Waiver

NPI Number: 1346737764

Taxonomy: 320800000X - Community Based Residential Treatment Facility, Mental Illness
A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.

CLIA Record

Field Name	Field Value
CLIA Number	05D2160120
LAB Type	Other - CRISIS RESIDENTIAL
Facility Name	VALLEY STAR CRISIS RESIDENTIAL TREATMENT MORONGO OASIS
Street	60805 29 PALMS HIGHWAY
City	JOSHUA TREE
State	CA
ZIP	92252
Phone	760 974-5990
CertificateType	4
CertificateEffectiveDate	1/4/2023
CertificateExpirationDate	1/3/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024