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General NPI Number Information
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NPI Number | 1376482521
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Entity Type | Organization
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Legal Business Name | 417 SOUTH RIVER LLC
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Dates
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Enumeration Date | 03/25/2026
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Last Update Date | 03/25/2026
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Provider Practice Location Address
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Address Line | 45902 OASIS ST STE B
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City | INDIO
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State | CA
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Zip | 92201-4580
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Country | US
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Telephone | 844-417-3417
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Fax | 442-282-1100
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Provider Business Mailing Address
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Address Line | 74075 EL PASEO STE A5
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City | PALM DESERT
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State | CA
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Zip | 92260-4118
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Country | US
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Telephone | 844-417-3417
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Fax | 442-282-1100
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Authorized Official
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Title or Position | OWNER
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Name | STEVIE KUHN
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Credential |
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Telephone | 760-485-6563
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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