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General NPI Number Information
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NPI Number | 1700903515
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Entity Type | Organization
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Legal Business Name | FAMILY CRISIS CENTER
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Dates
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Enumeration Date | 03/25/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 10315 WOODLEY AVE STE 213
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City | GRANADA HILLS
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State | CA
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Zip | 91344-6950
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Country | US
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Telephone | 818-999-5688
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5164
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City | WEST HILLS
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State | CA
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Zip | 91308-5164
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Country | US
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Telephone | 818-999-5688
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Fax |
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Authorized Official
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Title or Position | MARRIAGE FAMILY THERAPIST
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Name | MR. EEDWARD FARRELL
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Credential | MFT
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Telephone | 818-999-5688
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 36451
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License Number State | CA
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