Organization
DESIGN FOR CHANGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIKI HUNTER (CFO)
(818) 497-8177
Entity
Organization
Contact information
Practice address
40516 MILAN DR, PALMDALE, CA 93551-2536
(661) 942-1026
Mailing address
1066 E AVENUE J, LANCASTER, CA 93535-3870
(661) 942-1026
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
190795CP
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
190795CP
STATE LICENSE
CA
Enumeration date
04/14/2017
Last updated
12/12/2017
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