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Organization
SOUTHLAND MARRIAGE AND FAMILY
Active
Organization
SOUTHLAND MARRIAGE AND FAMILY
Active
Other names
Southland Mental Health Alliance
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEPHEN THOMAS PRYSTASH LMFT (DIRECTOR)
(951) 526-4118
Entity
Organization
Contact information
Practice address
28364 VINCENT MORAGA DR, F, TEMECULA, CA 92590-3656
(951) 526-4118
(951) 602-6166
Mailing address
28364 VINCENT MORAGA DR, F, TEMECULA, CA 92590-3656
(951) 526-4118
(951) 602-6166
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
MFC24093
CA
Other
Enumeration date
12/09/2015
Last updated
12/09/2015
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