Provider Demographics
NPI:1710443940
Name:CALIFORNIA BEHAVIORAL HEALTH, LLC
Entity Type:Organization
Organization Name:CALIFORNIA BEHAVIORAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEGERE
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:951-764-3950
Mailing Address - Street 1:67782 E PALM CANYON DR STE B104-205
Mailing Address - Street 2:
Mailing Address - City:CATHEDRAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:92234-5433
Mailing Address - Country:US
Mailing Address - Phone:760-459-3736
Mailing Address - Fax:760-459-3607
Practice Address - Street 1:37066 BANKSIDE DR
Practice Address - Street 2:
Practice Address - City:CATHEDRAL CITY
Practice Address - State:CA
Practice Address - Zip Code:92234-7815
Practice Address - Country:US
Practice Address - Phone:760-459-3736
Practice Address - Fax:760-459-3607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-12
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder