DESERT BLOOM RECOVERY LLC NPI 1811534811

NPI Information

NPI: 1811534811
Provider Name: DESERT BLOOM RECOVERY LLC
Classification: Clinic/Center - 261QR0405X
Entity Type: Organization

Specialization: Rehabilitation, Substance Use Disorder

CLIA Number: 05D2220206

Address:
14286 CALIFORNIA AVE STE 102
VICTORVILLE, CA
ZIP 92392
Phone: (877) 706-2650
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DESERT BLOOM RECOVERY LLC is a rehabilitation and substance use disorder clinic center in Victorville, CA. DESERT BLOOM RECOVERY LLC NPI is 1811534811. The provider is registered as an organization entity type.

The provider's business location address is:

14286 CALIFORNIA AVE STE 102
VICTORVILLE, CA
ZIP 92392-911
Phone: (877) 706-2650

The provider's authorized official is Michael Forcen .
The authorized official title is Owner and has the following contact phone number (877) 706-2650.

The CLIA number assigned to this NPI record is 05D2220206 - other - substance abuse outpt fac with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/9/2019 and was last updated on 12/9/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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