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General NPI Number Information
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NPI Number | 1821326158
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Entity Type | Organization
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Legal Business Name | BOUNDARIES FAMILY COUNSELING &LICENSED CLINICAL SOCIAL WORKER CORP.
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Dates
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Enumeration Date | 11/24/2009
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Last Update Date | 02/02/2011
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Provider Practice Location Address
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Address Line | 135 E 3RD AVE STE. B
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City | ESCONDIDO
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State | CA
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Zip | 92025-4252
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Country | US
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Telephone | 760-705-8468
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Fax | 760-735-2922
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Provider Business Mailing Address
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Address Line | 105 N ROSE ST STE. 211
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City | ESCONDIDO
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State | CA
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Zip | 92027-7222
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Country | US
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Telephone | 760-705-8468
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Fax | 760-735-2922
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | MS. HOLLY HASTINGS GINES
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Credential | LCSW
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Telephone | 858-212-4454
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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 | LCS 20560
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License Number State | CA
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