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General NPI Number Information
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NPI Number | 1760932800
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Entity Type | Organization
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Legal Business Name | THE CENTER FOR FAMILY UNITY
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Dates
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Enumeration Date | 10/13/2016
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Last Update Date | 10/13/2016
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Provider Practice Location Address
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Address Line | 1029 OLIVE AVE
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City | RAMONA
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State | CA
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Zip | 92065-1511
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Country | US
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Telephone | 619-884-0601
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Fax |
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Provider Business Mailing Address
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Address Line | 3625 RUFFIN RD STE 302
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City | SAN DIEGO
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State | CA
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Zip | 92123-1832
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Country | US
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Telephone | 619-884-0601
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PROF. KELLYE LAUGHERY
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Credential | MFT, RPT-S
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Telephone | 619-884-0601
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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 | 49206
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 49206
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License Number State | CA
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