Provider Demographics
NPI:1760101174
Name:CALM WATERS FAMILY THERAPY, INC.
Entity Type:Organization
Organization Name:CALM WATERS FAMILY THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP, SECRETARY, TREASURER
Authorized Official - Prefix:MR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:MARI
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:951-523-0776
Mailing Address - Street 1:25060 HANCOCK AVE STE 103-109
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-5930
Mailing Address - Country:US
Mailing Address - Phone:951-523-0776
Mailing Address - Fax:
Practice Address - Street 1:39681 AVENIDA ACACIAS
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-2201
Practice Address - Country:US
Practice Address - Phone:951-523-0776
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-26
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty