Provider Demographics
NPI:1548748817
Name:NEBO, MICHAEL (CADC-1)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:NEBO
Suffix:
Gender:M
Credentials:CADC-1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46900 MONROE ST STE 101A
Mailing Address - Street 2:
Mailing Address - City:INDIO
Mailing Address - State:CA
Mailing Address - Zip Code:92201-4828
Mailing Address - Country:US
Mailing Address - Phone:760-863-7940
Mailing Address - Fax:
Practice Address - Street 1:46900 MONROE ST STE 101A
Practice Address - Street 2:
Practice Address - City:INDIO
Practice Address - State:CA
Practice Address - Zip Code:92201-4828
Practice Address - Country:US
Practice Address - Phone:760-863-7940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-30
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No171M00000XOther Service ProvidersCase Manager/Care Coordinator