Provider Demographics
NPI:1518475987
Name:HI-DESERT MEMORIAL HEALTH CARE DISTRICT
Entity Type:Organization
Organization Name:HI-DESERT MEMORIAL HEALTH CARE DISTRICT
Other - Org Name:MORONGO BASIN COMMUNITY HEALTH CENTER-SR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHMALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-820-9229
Mailing Address - Street 1:6530 LA CONTENTA RD STE 100
Mailing Address - Street 2:
Mailing Address - City:YUCCA VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92284-7313
Mailing Address - Country:US
Mailing Address - Phone:760-820-9229
Mailing Address - Fax:760-820-9228
Practice Address - Street 1:6380 SPLIT ROCK AVE STE 103
Practice Address - Street 2:
Practice Address - City:29 PALMS
Practice Address - State:CA
Practice Address - Zip Code:92277-2550
Practice Address - Country:US
Practice Address - Phone:760-365-9305
Practice Address - Fax:866-732-0113
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HI-DESERT MEMORIAL HEALTH CARE DISTRICT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-01-18
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)