Organization
DYNAMIC TRANSFORMATIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY HITCHCOCK CADC - CAS (CEO)
(949) 280-6166
Entity
Organization
Contact information
Practice address
1247 CANTANIA DR, REDLANDS, CA 92374-4748
(800) 417-0485
(909) 335-2804
Mailing address
101 E REDLANDS BLVD STE 200, REDLANDS, CA 92373-4724
(800) 417-0485
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP2500X
Professional Counselor
—
—
106H00000X
Marriage & Family Therapist
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
06/30/2017
Last updated
06/30/2017
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