Provider Demographics
NPI:1396281630
Name:DESERT COVE AT DESERT HOT SPRINGS,INC
Entity type:Organization
Organization Name:DESERT COVE AT DESERT HOT SPRINGS,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ERIKA
Authorized Official - Middle Name:L
Authorized Official - Last Name:HEYWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:LVN
Authorized Official - Phone:760-671-7820
Mailing Address - Street 1:13660 MOUNTAIN VIEW RD
Mailing Address - Street 2:
Mailing Address - City:DESERT HOT SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92240-6454
Mailing Address - Country:US
Mailing Address - Phone:760-671-7820
Mailing Address - Fax:760-671-7713
Practice Address - Street 1:13660 MOUNTAIN VIEW RD
Practice Address - Street 2:
Practice Address - City:DESERT HOT SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92240-6454
Practice Address - Country:US
Practice Address - Phone:760-671-7820
Practice Address - Fax:760-671-7713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-10
Last Update Date:2017-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA336426550311500000X, 310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)