High Desert Child Adolescent And Family Services Center, Inc.

(<Unavail>)

Marriage & Family Therapist

Behavioral Health & Social Service Providers

16248 Victor St, Victorville, CA 92395-3934

PECOS Enrollment

Based on the most recent information from CMS, provider High Desert Child Adolescent And Family Services Center, Inc. does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1548495260
Provider Type
Organization
Full Name
High Desert Child Adolescent And Family Services Center, Inc.
Other Name
<Unavail>

Subpart
No
Enumeration Date
5/26/2009
Last Updated
5/26/2009

Contact Information

Practice Location

16248 Victor St, Victorville, CA 92395-3934

(760) 243-7151

(760) 952-1432

Mailing Location

PO Box 3275, Victorville, CA 92393-3275

(760) 243-7151

(760) 952-1432

Authorized Official

Burklow, Cindi E. (Executive Director)

(760) 243-7151

Provider Taxonomies

Code	Description	License
Code 106H00000X Primary	Description Marriage & Family Therapist Behavioral Health & Social Service Providers	License 29347 California
Code 106H00000X	Description Marriage & Family Therapist Behavioral Health & Social Service Providers	License 53676 California

High Desert Child Adolescent And Family Services Center, Inc.

(<Unavail>)

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Authorized Official

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Tamayo Manrique, Nelcy Yohanna

Mcnally, Zenaida Leeanne

Watson Family Service

Lebaron, Melody

Prickett, Patricia Elvera

Prendergast, Patricia J

Darnell, Melissa Christine

King-Terry, Pamela

Licon, Joseph

Green, Mercedes D