Organization
A NEW CREATION CHILD, INDIVIDUAL & FAMILY COUNSELING TREATMENT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAULETTE DOUGLAS LMFT (PRESIDENT & CEO)
(310) 963-7174
Entity
Organization
Contact information
Practice address
23800 SUNNYMEAD BLVD STE D, MORENO VALLEY, CA 92553-7731
(310) 420-5341
(888) 313-0140
Mailing address
23800 SUNNYMEAD BLVD STE D, MORENO VALLEY, CA 92553-7731
(310) 963-7174
(888) 313-0140
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
LMFT 49399
CA
Other
Enumeration date
11/22/2015
Last updated
03/25/2019
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