Provider Demographics
NPI:1013114776
Name:DUAL DIAGNOSIS MANAGEMENT, LLC DBA PALMSPRINGS SERENITY RETREAT
Entity Type:Organization
Organization Name:DUAL DIAGNOSIS MANAGEMENT, LLC DBA PALMSPRINGS SERENITY RETREAT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CARTWRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-345-3200
Mailing Address - Street 1:210 WESTWOOD PL
Mailing Address - Street 2:SUITE 120
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-7554
Mailing Address - Country:US
Mailing Address - Phone:954-587-7771
Mailing Address - Fax:954-587-8622
Practice Address - Street 1:2095 N INDIAN CANYON DR
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-3019
Practice Address - Country:US
Practice Address - Phone:954-587-7771
Practice Address - Fax:954-587-8622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-27
Last Update Date:2022-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA330014CP324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility