Provider Demographics
NPI:1912213968
Name:INSTITUTE OF ADVANCED STUDIES
Entity Type:Organization
Organization Name:INSTITUTE OF ADVANCED STUDIES
Other - Org Name:NEW HORIZONS COUNSELING
Other - Org Type:Other Name
Authorized Official - Title/Position:BOARD OF DIRECTORS
Authorized Official - Prefix:
Authorized Official - First Name:BURT
Authorized Official - Middle Name:
Authorized Official - Last Name:WINER
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:714-612-4464
Mailing Address - Street 1:PO BOX 2086
Mailing Address - Street 2:
Mailing Address - City:YUCCA VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92286-2086
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:56020 SANTA FE TRL
Practice Address - Street 2:
Practice Address - City:YUCCA VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92284-3148
Practice Address - Country:US
Practice Address - Phone:760-369-0294
Practice Address - Fax:760-369-0295
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-27
Last Update Date:2010-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC48268251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health