Provider Demographics
NPI:1619796794
Name:BENEFICIAL CDC
Entity type:Organization
Organization Name:BENEFICIAL CDC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:HODGDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-596-2415
Mailing Address - Street 1:44489 TOWN CENTER WAY # D351
Mailing Address - Street 2:
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92260-2723
Mailing Address - Country:US
Mailing Address - Phone:760-702-4486
Mailing Address - Fax:
Practice Address - Street 1:44489 TOWN CENTER WAY # D351
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92260-2723
Practice Address - Country:US
Practice Address - Phone:760-702-4486
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-07
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty