Provider Demographics
NPI:1437379039
Name:PALOMAR FAMILY COUNSELING SERVICE, INC.
Entity Type:Organization
Organization Name:PALOMAR FAMILY COUNSELING SERVICE, INC.
Other - Org Name:VISTA SUB
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:IRENE
Authorized Official - Middle Name:
Authorized Official - Last Name:SAPER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, MFT
Authorized Official - Phone:760-741-2660
Mailing Address - Street 1:945 VALE TERRACE DR
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92084-5213
Mailing Address - Country:US
Mailing Address - Phone:760-630-3505
Mailing Address - Fax:760-630-7156
Practice Address - Street 1:945 VALE TERRACE DR
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92084-5213
Practice Address - Country:US
Practice Address - Phone:760-630-3505
Practice Address - Fax:760-630-7156
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA=========OtherEIN