Organization
AVANT GARDE COMMUNITY COUNSELING CENTER
Active
Other names
Avant Garde Foster Family Agency
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREGORY ESTRAVIT (CEO)
(951) 735-5300
Entity
Organization
Contact information
Practice address
1655 E 6TH ST, SUITE A 4-C, CORONA, CA 92879-1732
(951) 735-5300
(951) 735-9335
Mailing address
1655 E 6TH ST, SUITE A 4-D, CORONA, CA 92879-1732
(951) 735-5300
(951) 735-9335
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C2552459
BUSINESS LICENSE
CA
Enumeration date
03/10/2014
Last updated
12/02/2014
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