BROCK DEVERE CARTER JENIKOVSKY

INDIO, CA
NPI1730936642
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA  A051980920)
Enumeration Date2024-04-30
Last Update Date2024-04-30
Business Address
Mr. BROCK DEVERE CARTER JENIKOVSKY CADC-II, ICADC
44359 PALM ST
INDIO, CA 92201-3116
Phone number: 760-342-6616
Mailing Address
Mr. BROCK DEVERE CARTER JENIKOVSKY CADC-II, ICADC
51165 EISENHOWER DR APT B
LA QUINTA, CA 92253-3084
Phone number: 760-883-7441
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