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General NPI Number Information
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NPI Number | 1275201022
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Entity Type | Individual
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Provider Name | SCOTT WARD CADC CAS
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Gender | Male
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Dates
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Enumeration Date | 09/04/2021
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Last Update Date | 09/04/2021
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Provider Practice Location Address
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Address Line | 1473 E GEM CIR
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City | PALM SPRINGS
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State | CA
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Zip | 92262-2354
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Country | US
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Telephone | 760-464-2611
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Fax |
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Provider Business Mailing Address
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Address Line | 1473 E GEM CIR
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City | PALM SPRINGS
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State | CA
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Zip | 92262-2354
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Country | US
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Telephone | 760-464-2611
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0802X
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Taxonomy Name | Addiction Psychiatry Physician
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License Number | TBD
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number | TBD
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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