Provider Demographics
NPI:1730719451
Name:DRM PSYCHOLOGICAL SERVICES & RESSOURCE CENTER
Entity type:Organization
Organization Name:DRM PSYCHOLOGICAL SERVICES & RESSOURCE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:ETIENNE
Authorized Official - Last Name:LAFALAISE
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:561-433-8123
Mailing Address - Street 1:2324 S CONGRESS AVE STE 2F
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33406-7668
Mailing Address - Country:US
Mailing Address - Phone:561-433-8123
Mailing Address - Fax:561-433-8011
Practice Address - Street 1:2324 S CONGRESS AVE STE 2F
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33406-7668
Practice Address - Country:US
Practice Address - Phone:561-433-8123
Practice Address - Fax:561-433-8011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-22
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)