# BUCHANAN TRAUMA RECOVERY FAMILY THERAPY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1467122192
- **Authorized official:** ILESE BUCHANAN MS (OWNER/LMFT)
- **Authorized official phone:** (951) 344-6428

## Contact information

- **Practice address:** 1410 3RD ST STE 12, RIVERSIDE, CA 92507-3422
- **Practice address phone:** (951) 344-6428
- **Mailing address:** PO BOX 52015, RIVERSIDE, CA 92517-3015

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | — | NULL | Yes |
| 106H00000X | Marriage & Family Therapist | — | — | Yes |

## Other

- **Enumeration date:** 09/14/2021
- **Last updated:** 09/14/2021