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General NPI Number Information
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NPI Number | 1417643156
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Entity Type | Organization
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Legal Business Name | ELIS FAMILY COUNSELING SERVICES
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Dates
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Enumeration Date | 04/14/2023
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Last Update Date | 04/14/2023
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Provider Practice Location Address
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Address Line | 383 N MAIN ST
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City | POMONA
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State | CA
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Zip | 91768-3826
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Country | US
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Telephone | 909-708-6615
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 7520
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City | NORCO
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State | CA
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Zip | 92860-8084
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Country | US
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Telephone | 909-708-6615
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JANE AKPONYE
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Credential |
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Telephone | 909-713-4077
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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