Basic Information
| Provider Information | |||||||||
| NPI: | 1013447986 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HOLISTIC CURE AND CARE CENTER, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 72877 DINAH SHORE DR STE 103 | ||||||||
| Address2: | |||||||||
| City: | RANCHO MIRAGE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 922702709 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3103833551 | ||||||||
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| Practice Location | |||||||||
| Address1: | 9939 MAGNOLIA AVE | ||||||||
| Address2: | |||||||||
| City: | RIVERSIDE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 925033528 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8555057467 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/14/2017 | ||||||||
| LastUpdateDate: | 02/26/2018 | ||||||||
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| AuthorizedOfficialLastName: | BAHADOR | ||||||||
| AuthorizedOfficialFirstName: | ALBORZ | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 3103833551 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | PSYD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103T00000X | CA | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Psychologist |
No ID Information.