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General NPI Number Information
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NPI Number | 1841606639
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Entity Type | Organization
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Legal Business Name | THE KILOBY CENTER FOR RECOVERY INC
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Dates
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Enumeration Date | 07/01/2014
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Last Update Date | 07/29/2025
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Provider Practice Location Address
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Address Line | 71777 SAN JACINTO DR STE 102
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City | RANCHO MIRAGE
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State | CA
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Zip | 92270-4457
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Country | US
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Telephone | 442-666-8526
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Fax |
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Provider Business Mailing Address
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Address Line | 71777 SAN JACINTO DR STE 102
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City | RANCHO MIRAGE
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State | CA
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Zip | 92270-4457
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Country | US
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Telephone | 442-666-8526
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | ALI BEHESHTI
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Credential |
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Telephone | 619-929-7956
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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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 | 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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Taxonomy #3
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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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 | 261QR0401X
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Taxonomy Name | Comprehensive Outpatient Rehabilitation Facility (CORF)
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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