417 DESERT CITIES, LLC (NPI# 1750817383) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750817383 |
| Entity Type | Organization |
| Organization Name | 417 DESERT CITIES, LLC |
| Practice Address |
73271 Fred Waring Dr Suite 103 Palm Desert CA 92260-2883 |
| Practice Telephone | 7605652998 |
| Practice Fax Number | 4422821100 |
| Mailing Telephone | 7605652998 |
| Mailing Fax Number | 4422821100 |
| Enumeration Date | 2017-05-02 |
| Last Update Date | 2019-07-02 |
| Authorized Official Name | MRS. STEVIE KUHN (PROGRAM DIRECTOR) |
| Authorized Official Telephone | 7605652998 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251S00000X | Community/Behavioral Health | Agencies | ||
| Y | 3245S0500X |
Substance Abuse Rehabilitation Facility Specialization: Substance Abuse Treatment, Children |
Residential Treatment Facilities |
| Street Address |
73271 FRED WARING DR SUITE 103 |
| City | PALM DESERT |
| State | CA |
| Zip Code | 92260-2883 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285902403 | Pain and Spine Center of The Desert Inc. | Clinic/Center | 73271 Fred Waring Dr, Suite 102, Palm Desert, CA 92260-2883 | 2011-12-02 |
| 1093313793 | Rachel Wright | Behavior Technician | 73271 Fred Waring Dr, Palm Desert, CALIFORNIA 92260 | 2020-10-14 |
| 1982202909 | Omar Alonso Rodriguez | Behavioral Analyst | 73271 Fred Waring Dr, Palm Desert, CA 92260-2883 | 2020-10-12 |
| 1982211207 | Anahi Michell Navarro | Behavioral Analyst | 73271 Fred Waring Dr, Palm Desert, CA 92260-2883 | 2020-09-30 |
| 1821604703 | Maryrose Cachola | Behavioral Analyst | 73271 Fred Waring Dr, Palm Desert, CA 92260-2883 | 2020-09-16 |
| 1104431113 | Sandra Hernandez Alonso | Behavior Technician | 73271 Fred Waring Dr, Palm Desert, CA 92260-2883 | 2020-09-15 |
| 1689206930 | Jessica Lupe Lucero | Behavior Technician | 73271 Fred Waring Dr, Palm Desert, CA 92260-2883 | 2020-02-05 |
| 1174155436 | Jennyfer Gonzalez | Behavioral Analyst | 73271 Fred Waring Dr, Palm Desert, CA 92260-2883 | 2020-02-05 |
| 1518597236 | Mohannad Jaghamah | Behavior Technician | 73271 Fred Waring Dr, Palm Desert, CA 92260-2883 | 2020-01-22 |
| 1053954818 | Joan Avila | Behavioral Analyst | 73271 Fred Waring Dr, Palm Desert, CA 92260-2883 | 2019-10-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003414202 | Arianna D Aguilar | Behavioral Analyst | 7410 Highway 111 Suite 102, Palm Desert, CA 92260 | 2020-10-12 |
| 1063053098 | Sylvia Ann Trapuzzano | Marriage & Family Therapist | 74-040 Highway IIi, Suite L-202, Palm Desert, CA 92260 | 2019-10-01 |
| 1477011153 | Alexis Ivonne Corrales | Behavior Technician | 74-710 Ca-111, Ste #102, Palm Desert, CA 92260 | 2019-03-12 |
| 1992272421 | Sarah Baik | Pharmacist | 72314 Ca-111, Palm Desert, CA 92260 | 2018-11-02 |
| 1104329820 | Oz Med, Inc. | Pharmacy | 44150 Town Center Way, Ste B4, Palm Desert, CA 92260 | 2018-03-09 |
| 1598272577 | Eisenhower Medical Center | General Acute Care Hospital | 74020 Alessandro Drive, Suite B, Palm Desert, CA 92260 | 2017-12-29 |
| 1225540180 | Dr Fatemeh Hadjian D.d.s. P.a. | Dentist | 74000 Country Club Ste B1, Palm Desert, CA 92260 | 2017-11-01 |
| 1871032185 | Brianne Lee Stoddard | Behavioral Analyst | 41555 Cook Street, Suite 100, Palm Desert, CA 92260 | 2017-02-20 |
| 1275072720 | Michael Giordano Jerez | Chiropractor | 72840 Ca - 111 Suite 2, Palm Desert, CA 92260 | 2017-02-16 |
| 1982150785 | Joshua W Cartter Dds Inc | Dentist | 72415 Park View, Palm Desert, CA 92260 | 2016-08-31 |
| Find all providers in zip 92260 | ||||
| Taxonomy Code | 3245S0500X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| Specialization | Substance Abuse Treatment, Children |
| A facility or distinct part of a facility 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. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689275620 | Monroe Operations, LLC | Substance Abuse Rehabilitation Facility | 80 W Nicasio, San Geronimo, CA 94963 | 2020-11-05 |
| 1013518042 | Monroe Operations, LLC | Substance Abuse Rehabilitation Facility | 1208 Via Aracena, Camarillo, CA 93010-7440 | 2020-11-05 |
| 1609477645 | Monroe Operations, LLC | Substance Abuse Rehabilitation Facility | 1850 Calle Alberca, Camarillo, CA 93010-1811 | 2020-11-05 |
| 1467053736 | Monroe Operations, LLC | Substance Abuse Rehabilitation Facility | 615 Bugeia Ln, Novato, CA 94945-1517 | 2020-11-04 |
| 1376144642 | Monroe Operations, LLC | Substance Abuse Rehabilitation Facility | 100 Avocado Pl, Camarillo, CA 93010-8467 | 2020-11-04 |
| 1285235556 | Monroe Operations, LLC | Substance Abuse Rehabilitation Facility | 7210 Johnston Rd, Pleasanton, CA 94588-9466 | 2020-11-04 |
| 1780282988 | Muir Wood LLC | Substance Abuse Rehabilitation Facility | 2891 I Street Ext, Petaluma, CA 94952-9521 | 2020-10-12 |
| 1720692577 | Muir Wood, LLC. | Substance Abuse Rehabilitation Facility | 1743 Skillman Lane, Petaluma, CA 94952-9495 | 2020-08-31 |
| 1598376816 | Muir Wood LLC | Substance Abuse Rehabilitation Facility | 6868 Cold Springs Rd, Penngrove, CA 94951-9722 | 2020-08-11 |
| 1770194060 | Monroe Operations, LLC | Substance Abuse Rehabilitation Facility | 195 S Peralta Hills Dr, Anaheim, CA 92807-3424 | 2020-08-11 |
| Find all providers with the same taxonomy | ||||
| City | PALM DESERT |
| Zip Code | 92260 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.