Organization
AWARENESS PROGRAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KAREN C. WIKERT (ADMINISTRATOR)
(760) 342-1233
Entity
Organization
Contact information
Practice address
45926 OASIS ST, INDIO, CA 92201-4559
(760) 342-1233
(760) 342-5344
Mailing address
45926 OASIS ST, INDIO, CA 92201-4559
(760) 342-1233
(760) 342-5344
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
05/16/2012
Last updated
01/24/2017
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