Provider Demographics
NPI:1144597949
Name:ALL DESERT WELLNESS CENTERS
Entity Type:Organization
Organization Name:ALL DESERT WELLNESS CENTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:KIRKPATRICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-219-6909
Mailing Address - Street 1:74200 HIGHWAY 111
Mailing Address - Street 2:
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92260-4138
Mailing Address - Country:US
Mailing Address - Phone:760-797-5151
Mailing Address - Fax:
Practice Address - Street 1:74200 HIGHWAY 111
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92260-4138
Practice Address - Country:US
Practice Address - Phone:760-219-9693
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-22
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9999106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty