Provider Demographics
NPI:1184147761
Name:CALIFORNIA FAMILY LIFE CENTER
Entity type:Organization
Organization Name:CALIFORNIA FAMILY LIFE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HR MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:SNOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-765-6955
Mailing Address - Street 1:PO BOX 727
Mailing Address - Street 2:
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92546-0727
Mailing Address - Country:US
Mailing Address - Phone:951-765-6955
Mailing Address - Fax:
Practice Address - Street 1:930 N STATE ST
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92543-1473
Practice Address - Country:US
Practice Address - Phone:951-765-6955
Practice Address - Fax:951-765-6966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-25
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty