Healthcare Provider Details

I. General information

NPI: 1467394825
Provider Name (Legal Business Name): DESERT WELLNESS NON MEDICAL GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2026
Last Update Date: 04/07/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2390 N TRAIL CIR
PALM SPRINGS CA
92262-3132
US

IV. Provider business mailing address

600 W BROADWAY 700-100A PMB 70224
SAN DIEGO CA
92101-3311
US

V. Phone/Fax

Practice location:
  • Phone: 916-716-2562
  • Fax: 760-406-5993
Mailing address:
  • Phone: 442-230-6492
  • Fax: 760-406-5993

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: DONALD RAYMOND HIERS
Title or Position: CEO
Credential: CMA
Phone: 442-230-6492