Provider Demographics
NPI:1568899417
Name:DESERT MARRIAGE FAMILY COUNSELING INC
Entity Type:Organization
Organization Name:DESERT MARRIAGE FAMILY COUNSELING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGG
Authorized Official - Middle Name:
Authorized Official - Last Name:HOMME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-563-6623
Mailing Address - Street 1:PO BOX 6753
Mailing Address - Street 2:
Mailing Address - City:LA QUINTA
Mailing Address - State:CA
Mailing Address - Zip Code:92248-6753
Mailing Address - Country:US
Mailing Address - Phone:760-777-7720
Mailing Address - Fax:442-666-8363
Practice Address - Street 1:43585 MONTEREY AVE STE 1
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92260-9398
Practice Address - Country:US
Practice Address - Phone:760-777-7720
Practice Address - Fax:760-452-8532
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-07
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 37832106H00000X
261Q00000X, 261QM0850X, 261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthGroup - Single Specialty
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental HealthGroup - Single Specialty