| Church Counseling Service Inc | |
|
188 W Langston St Upland CA 91786-3123 | |
| (909) 982-8687 | |
| Not Available |
| Full Name | Church Counseling Service Inc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 188 W Langston St, Upland, California |
| Authorized Official Name and Position | Richard Fort (PRESIDENT) |
| Authorized Official Contact | 9099828687 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Church Counseling Service Inc 188 W Langston St Upland CA 91786-3123 Ph: (909) 982-8687 | Church Counseling Service Inc 188 W Langston St Upland CA 91786-3123 Ph: (909) 982-8687 |
| NPI Number | 1265711642 |
|---|---|
| Provider Enumeration Date | 08/16/2011 |
| Last Update Date | 08/16/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265711642 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | MF013902 (California) | Primary |
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