Organization
INSTITUTE FOR FAMILY CENTERED SERVICES, INC.
Active
Other names
California Mentor
Organization subpart
No
Provider details
NPI number
Authorized official
MARY PATRICIA RODENBERG-ROBERTS (VICE PRESIDENT & SENIOR ASST GENERA)
(952) 836-2234
Entity
Organization
Contact information
Practice address
790 S. STATE STREET SUITE #6, SAN JACINTO, CA 92583
(951) 782-0040
Mailing address
6600 FRANCE AVENUE SOUTH SUITE 350, EDINA, MN 55435
(800) 388-5150
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33PYNCX
—
CA
Enumeration date
04/01/2019
Last updated
05/24/2024
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