Provider Demographics
NPI:1417643156
Name:ELIS FAMILY COUNSELING SERVICES
Entity Type:Organization
Organization Name:ELIS FAMILY COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:AKPONYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-713-4077
Mailing Address - Street 1:PO BOX 7520
Mailing Address - Street 2:
Mailing Address - City:NORCO
Mailing Address - State:CA
Mailing Address - Zip Code:92860-8084
Mailing Address - Country:US
Mailing Address - Phone:909-708-6615
Mailing Address - Fax:
Practice Address - Street 1:383 N MAIN ST
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91768-3826
Practice Address - Country:US
Practice Address - Phone:909-708-6615
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-14
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty