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General NPI Number Information
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NPI Number | 1558443374
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Entity Type | Organization
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Legal Business Name | LA FAMILIA FAMILY TREATMENT SERVICES
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Dates
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Enumeration Date | 10/20/2006
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 1905 COLLEGE AVE
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City | SANTA ANA
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State | CA
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Zip | 92706-2334
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Country | US
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Telephone | 714-479-0120
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Fax | 714-479-0153
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Provider Business Mailing Address
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Address Line | 1905 N. COLLEGE AVE.
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City | SANTA ANA
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State | CA
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Zip | 92706
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Country | US
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Telephone | 714-479-0120
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Fax | 714-479-0153
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Authorized Official
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Title or Position | PROJECT DIRECTOR
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Name | ISABEL C MELLONI
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Credential | MA PSYCHOLOGY
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Telephone | 714-479-0120
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 30001DN
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number | 300010DN
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License Number State | CA
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