Provider Demographics
NPI:1598330698
Name:PALM SPRINGS COMMUNITY HEALTH CENTER CORP
Entity Type:Organization
Organization Name:PALM SPRINGS COMMUNITY HEALTH CENTER CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:REBECA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-510-0390
Mailing Address - Street 1:14411 COMMERCE WAY
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33016-1596
Mailing Address - Country:US
Mailing Address - Phone:786-218-1733
Mailing Address - Fax:
Practice Address - Street 1:14411 COMMERCE WAY
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33016-1596
Practice Address - Country:US
Practice Address - Phone:786-218-1733
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-21
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty