Organization
HUMANITY CENTER 4 CHANGE
Active
Other names
HumanityCenter4Change
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TERESA ETHRIDGE DR. (PSYCHOLOGIST/INTERN)
(951) 531-6785
Entity
Organization
Contact information
Practice address
9791 ARROW RTE, RANCHO CUCAMONGA, CA 91730-3602
(951) 531-6785
Mailing address
5001 W FLORIDA AVE SPC 688, HEMET, CA 92545-3822
(951) 531-6785
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QC1500X
Community Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
05/04/2024
Last updated
12/28/2024
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