Provider Demographics
NPI:1790120392
Name:STILLPOINT FAMILY RESOURCES
Entity Type:Organization
Organization Name:STILLPOINT FAMILY RESOURCES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROSS
Authorized Official - Middle Name:
Authorized Official - Last Name:PORTER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:818-704-1327
Mailing Address - Street 1:PO BOX 5103
Mailing Address - Street 2:
Mailing Address - City:WEST HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91308-5103
Mailing Address - Country:US
Mailing Address - Phone:818-704-1327
Mailing Address - Fax:818-704-9117
Practice Address - Street 1:6740 FALLBROOK AVE
Practice Address - Street 2:SUITE 107
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91307-3935
Practice Address - Country:US
Practice Address - Phone:818-704-1327
Practice Address - Fax:818-704-9117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-08
Last Update Date:2013-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA63802251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health