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General NPI Number Information
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NPI Number | 1154674836
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Entity Type | Organization
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Legal Business Name | CHARTER HOME HEALTH OF THE DESERT LLC
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Dates
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Enumeration Date | 10/18/2012
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Last Update Date | 10/18/2012
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Provider Practice Location Address
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Address Line | 72855 FRED WARING DR SUITE A4
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City | PALM DESERT
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State | CA
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Zip | 92260-9368
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Country | US
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Telephone | 909-825-2969
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Fax | 909-825-8751
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Provider Business Mailing Address
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Address Line | 72855 FRED WARING DR SUITE A4
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City | PALM DESERT
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State | CA
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Zip | 92260-9368
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Country | US
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Telephone | 909-825-2969
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Fax | 909-825-8751
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | FRED FRANK
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Credential |
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Telephone | 951-316-4539
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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