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General NPI Number Information
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NPI Number | 1003561317
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Entity Type | Organization
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Legal Business Name | DESERT SERENITY, INC
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Dates
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Enumeration Date | 02/15/2022
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Last Update Date | 02/15/2022
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Provider Practice Location Address
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Address Line | 68896 CORRAL RD
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City | CATHEDRAL CITY
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State | CA
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Zip | 92234-4214
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Country | US
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Telephone | 760-397-7034
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Fax | 760-377-9003
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Provider Business Mailing Address
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Address Line | 68896 CORRAL RD
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City | CATHEDRAL CITY
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State | CA
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Zip | 92234-4214
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Country | US
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Telephone | 760-397-7034
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOSEPH SPEDALIERE
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Credential |
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Telephone | 760-397-7034
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385HR2055X
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Taxonomy Name | Child Mental Illness Respite Care
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 385HR2060X
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Taxonomy Name | Child Intellectual and/or Developmental Disabilities Respite Care
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 385HR2065X
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Taxonomy Name | Child Physical Disabilities Respite Care
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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