MEDICARE: PCD SENIOR 1

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1972205276
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PCD SENIOR 1

Provider Business Mailing Address
First Line	:	2150 N PALM CANYON DR
Second Line	:
City	:	PALM SPRINGS
State	:	CA
Zip	:	92262-2832
Country	:	US
Telephone Number	:	760-548-0970
Fax Number	:

Provider Business Practice Location Address
First Line	:	2150 N PALM CANYON DR
Second Line	:
City	:	PALM SPRINGS
State	:	CA
Zip	:	92262-2832
Country	:	US
Telephone Number	:	760-548-0970
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. JOSHUA LEVY
Credential	:
Telephone Number	:	213-503-2261

Provider Enumeration Date	:	03/20/2023
Last Update Date	:	04/25/2023

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Directions to “PCD SENIOR 1 ” Practice Location

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