Provider Demographics
NPI:1083231781
Name:TREEHOUSE CHILD THERAPY PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:TREEHOUSE CHILD THERAPY PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MONA
Authorized Official - Middle Name:
Authorized Official - Last Name:ORTON
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:909-238-1027
Mailing Address - Street 1:514 N CALIFORNIA AVE STE 13
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:CA
Mailing Address - Zip Code:92223-2120
Mailing Address - Country:US
Mailing Address - Phone:909-238-1027
Mailing Address - Fax:
Practice Address - Street 1:514 N CALIFORNIA AVE STE 13
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:CA
Practice Address - Zip Code:92223-2120
Practice Address - Country:US
Practice Address - Phone:909-238-1027
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-29
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health