=====================================================
General NPI Number Information
=====================================================
NPI Number | 1710834627
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CLOVERLEAF ENRICHMENT CENTER
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/11/2026
-----------------------------------------------------
Last Update Date | 03/11/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 655 OLEANDER AVE
-----------------------------------------------------
City | CHICO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95926-3924
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 530-206-0456
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 8
-----------------------------------------------------
City | OROVILLE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95965-0008
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 530-206-0456
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EXECUTIVE DIRECTOR
-----------------------------------------------------
Name | JULIE MARIE TOROK-MANGASARIAN
-----------------------------------------------------
Credential | LMFT
-----------------------------------------------------
Telephone | 530-206-0456
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------