NPI: 1750817383
Provider Name: 417 DESERT CITIES, LLC
Doing Business As: 417 RECOVERY
Classification: Substance Abuse Rehabilitation Facility - 3245S0500X
Entity Type: Organization
Specialization: Substance Abuse Treatment, Children
CLIA Number: 05D2220956
Address:
74075 EL PASEO STE A5
PALM DESERT, CA
ZIP 92260
Phone: (760) 565-2998
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417 DESERT CITIES, LLC is a substance abuse treatment and children substance abuse rehabilitation facility in Palm Desert, CA. The provider is a facility or distinct part of a facility for children that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of children with disorders in the use of drugs, alcohol, and other substances. Medical and supportive counseling services and education services are included. 417 DESERT CITIES, LLC NPI is 1750817383. The provider is registered as an organization entity type.
The provider Is Doing Business As 417 Recovery.
The provider's business location address is:
74075 EL PASEO STE A5
PALM DESERT, CA
ZIP 92260-118
Phone: (760) 565-2998
Fax: (442) 282-1100
The provider's authorized official is Stevie Kuhn .
The authorized official title is Owner/partner and has the following contact phone number (760) 565-2998.
The CLIA number assigned to this NPI record is 05D2220956 - ancillary testing site in health care center with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).
The enumeration date for this NPI number is 5/2/2017 and was last updated on 12/6/2023.