Provider Demographics
NPI:1992188544
Name:INSTITUTE FOR FAMILY CENTERED SERVICES INC.
Entity Type:Organization
Organization Name:INSTITUTE FOR FAMILY CENTERED SERVICES INC.
Other - Org Name:CA MENTOR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:REGIONAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:P
Authorized Official - Last Name:FERDINAND
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:562-556-4577
Mailing Address - Street 1:9166 ANAHEIM PL
Mailing Address - Street 2:SUITE 200
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-8547
Mailing Address - Country:US
Mailing Address - Phone:909-483-2505
Mailing Address - Fax:909-483-2119
Practice Address - Street 1:801 W SAN BERNARDINO RD
Practice Address - Street 2:
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91722-3621
Practice Address - Country:US
Practice Address - Phone:626-541-0120
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NATIONAL MENTOR HEALTHCARE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-07-01
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health