Provider Demographics
NPI:1992123871
Name:HIGH DESERT COUNSELING SERVICES
Entity type:Organization
Organization Name:HIGH DESERT COUNSELING SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER,DIRECTOR,CLINICAL SUPERVISOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JESSE
Authorized Official - Middle Name:LAYNE
Authorized Official - Last Name:JASAK
Authorized Official - Suffix:
Authorized Official - Credentials:MRAS, CSC
Authorized Official - Phone:661-524-9111
Mailing Address - Street 1:44349 LOWTREE AVE
Mailing Address - Street 2:SUITE 117
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-4167
Mailing Address - Country:US
Mailing Address - Phone:661-524-9111
Mailing Address - Fax:661-524-9101
Practice Address - Street 1:44349 LOWTREE AVE
Practice Address - Street 2:SUITE 117
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-4167
Practice Address - Country:US
Practice Address - Phone:661-524-9111
Practice Address - Fax:661-524-9101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-28
Last Update Date:2014-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility