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Organization
CHURCH COUNSELING SERVICE INC
Active
Organization
CHURCH COUNSELING SERVICE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD FORT MA MFT (PRESIDENT)
(909) 982-8687
Entity
Organization
Contact information
Practice address
188 W LANGSTON ST, UPLAND, CA 91786-3123
(909) 982-8687
Mailing address
188 W LANGSTON ST, UPLAND, CA 91786-3123
(909) 982-8687
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MF013902
CA
Other
Enumeration date
08/16/2011
Last updated
08/16/2011
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