Basic Information
| Provider Information | |||||||||
| NPI: | 1013578046 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | FLORECER THERAPY, FAMILY, MARRIAGE, AND CHILD, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7655 WINNETKA AVE UNIT 2741 | ||||||||
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| City: | WINNETKA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913967042 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8182571470 | ||||||||
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| Practice Location | |||||||||
| Address1: | 20300 VENTURA BLVD STE 330 | ||||||||
| Address2: | |||||||||
| City: | WOODLAND HILLS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913640904 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8059470984 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/20/2019 | ||||||||
| LastUpdateDate: | 06/20/2019 | ||||||||
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| AuthorizedOfficialLastName: | FLORES | ||||||||
| AuthorizedOfficialFirstName: | ANALIN | ||||||||
| AuthorizedOfficialMiddleName: | ALTAGRACIA | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8182571470 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| AuthorizedOfficialCredential: | LMFT | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QM0801X | Y | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) |
No ID Information.