Provider Demographics
NPI:1376009969
Name:FAMILY HORIZONS INC.
Entity Type:Organization
Organization Name:FAMILY HORIZONS INC.
Other - Org Name:ANTONIA TELLEZ, LMFT
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ANTONIA
Authorized Official - Middle Name:
Authorized Official - Last Name:TELLEZ
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:909-910-9279
Mailing Address - Street 1:10737 LAUREL ST STE 220
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-3837
Mailing Address - Country:US
Mailing Address - Phone:909-476-9556
Mailing Address - Fax:909-476-9557
Practice Address - Street 1:10737 LAUREL ST STE 220
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-3837
Practice Address - Country:US
Practice Address - Phone:909-476-9556
Practice Address - Fax:909-476-9557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-19
Last Update Date:2019-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty