Provider Demographics
NPI:1427536630
Name:THE PRIORITY CENTER ENDING THE GENERATIONAL CYCLE OF TRAUMA INC.
Entity Type:Organization
Organization Name:THE PRIORITY CENTER ENDING THE GENERATIONAL CYCLE OF TRAUMA INC.
Other - Org Name:AMHS PREVENTION CENTER IN HOME CRISIS STABILIZATION
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF PROGRAM OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:BILL
Authorized Official - Middle Name:RUSSELL
Authorized Official - Last Name:TORNQUIST
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:949-400-3096
Mailing Address - Street 1:1940 E DEERE AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-5718
Mailing Address - Country:US
Mailing Address - Phone:714-543-4333
Mailing Address - Fax:
Practice Address - Street 1:1940 E DEERE AVE STE 100
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-5718
Practice Address - Country:US
Practice Address - Phone:714-543-4333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-31
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management