Healthcare Provider Details

I. General information

NPI: 1760932800
Provider Name (Legal Business Name): THE CENTER FOR FAMILY UNITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2016
Last Update Date: 10/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1029 OLIVE AVE
RAMONA CA
92065-1511
US

IV. Provider business mailing address

3625 RUFFIN RD STE 302
SAN DIEGO CA
92123-1832
US

V. Phone/Fax

Practice location:
  • Phone: 619-884-0601
  • Fax:
Mailing address:
  • Phone: 619-884-0601
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number49206
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number49206
License Number StateCA

VIII. Authorized Official

Name: PROF. KELLYE LAUGHERY
Title or Position: OWNER
Credential: MFT, RPT-S
Phone: 619-884-0601