Provider Demographics
NPI:1548578669
Name:PRIMTE TIMER OF THE DESERT FOUNDATION
Entity Type:Organization
Organization Name:PRIMTE TIMER OF THE DESERT FOUNDATION
Other - Org Name:GOLDEN RAINBOW CENTER - SAGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:HARVEY
Authorized Official - Middle Name:ELLIOTT
Authorized Official - Last Name:STERN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-416-7790
Mailing Address - Street 1:700 E TAHQUITZ CANYON WAY
Mailing Address - Street 2:SUITE F
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-6764
Mailing Address - Country:US
Mailing Address - Phone:760-416-7790
Mailing Address - Fax:760-416-7786
Practice Address - Street 1:700 E TAHQUITZ CANYON WAY
Practice Address - Street 2:SUITE F
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-6764
Practice Address - Country:US
Practice Address - Phone:760-416-7790
Practice Address - Fax:760-416-7786
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-23
Last Update Date:2010-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No252Y00000XAgenciesEarly Intervention Provider Agency