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General NPI Number Information
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NPI Number | 1851113286
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Entity Type | Organization
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Legal Business Name | RECLAIM CENTER FOR MARRIAGE AND FAMILY THERAPY INC
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Dates
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Enumeration Date | 10/28/2024
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Last Update Date | 10/28/2024
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Provider Practice Location Address
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Address Line | 295 REDONDO AVE STE 201
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City | LONG BEACH
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State | CA
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Zip | 90803-5968
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Country | US
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Telephone | 562-270-2167
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Fax | 323-426-8815
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Provider Business Mailing Address
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Address Line | 295 REDONDO AVE STE 201
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City | LONG BEACH
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State | CA
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Zip | 90803-5968
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Country | US
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Telephone | 562-270-2167
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Fax | 323-426-8815
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Authorized Official
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Title or Position | OWNER
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Name | KAELA R PANGBURN
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Credential | LMFT
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Telephone | 562-270-2167
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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