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General NPI Number Information
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NPI Number | 1497322309
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Entity Type | Organization
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Legal Business Name | BEYOND THERAPY HEALING CENTER LICENSED CLINICAL SOCIAL WORKER INC.
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Dates
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Enumeration Date | 06/09/2021
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Last Update Date | 07/27/2021
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Provider Practice Location Address
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Address Line | 4193 FLAT ROCK DR STE 200
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City | RIVERSIDE
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State | CA
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Zip | 92505-7113
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Country | US
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Telephone | 951-292-4693
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Fax |
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Provider Business Mailing Address
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Address Line | 4193 FLAT ROCK DR STE 200
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City | RIVERSIDE
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State | CA
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Zip | 92505-7113
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ASHLEY WILLIS
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Credential |
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Telephone | 951-292-4693
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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