Provider Demographics
NPI:1013578046
Name:FLORECER THERAPY, FAMILY, MARRIAGE, AND CHILD, INC.
Entity Type:Organization
Organization Name:FLORECER THERAPY, FAMILY, MARRIAGE, AND CHILD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANALIN
Authorized Official - Middle Name:ALTAGRACIA
Authorized Official - Last Name:FLORES
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:818-257-1470
Mailing Address - Street 1:7655 WINNETKA AVE UNIT 2741
Mailing Address - Street 2:
Mailing Address - City:WINNETKA
Mailing Address - State:CA
Mailing Address - Zip Code:91396-7042
Mailing Address - Country:US
Mailing Address - Phone:818-257-1470
Mailing Address - Fax:
Practice Address - Street 1:20300 VENTURA BLVD STE 330
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-0904
Practice Address - Country:US
Practice Address - Phone:805-947-0984
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-20
Last Update Date:2019-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)