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Organization
THE FAMILY THERAPY CENTER CORP
Active
Organization
THE FAMILY THERAPY CENTER CORP
Active
Other names
The FAMILY THERAPY CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
KATELINE MEDINA M.S. (CEO/CFO)
(951) 836-6727
Entity
Organization
Contact information
Practice address
29995 TECHNOLOGY DR STE 103, MURRIETA, CA 92563-2633
(951) 384-1661
Mailing address
PO BOX 53573, RIVERSIDE, CA 92517-4573
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
NULL
106H00000X
Marriage & Family Therapist
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
NULL
261QM0850X
Adult Mental Health Clinic/Center
—
NULL
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
NULL
Other
Enumeration date
04/03/2024
Last updated
11/27/2024
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