Provider Demographics
NPI:1952440307
Name:WCHS, INC
Entity Type:Organization
Organization Name:WCHS, INC
Other - Org Name:EAST DESERT TREATMENT CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:FREITAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-347-0494
Mailing Address - Street 1:83912 AVENUE 45
Mailing Address - Street 2:SUITE 8
Mailing Address - City:INDIO
Mailing Address - State:CA
Mailing Address - Zip Code:92201-3338
Mailing Address - Country:US
Mailing Address - Phone:760-347-0494
Mailing Address - Fax:760-347-9064
Practice Address - Street 1:83912 AVENUE 45
Practice Address - Street 2:SUITE 8
Practice Address - City:INDIO
Practice Address - State:CA
Practice Address - Zip Code:92201-3338
Practice Address - Country:US
Practice Address - Phone:760-347-0494
Practice Address - Fax:760-347-9064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33-08261QM2800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHDC70126FMedicaid
CAHDC70126FMedicaid