Provider Demographics
NPI:1184338378
Name:WELLNESS CENTRUM FAMILY COUNSELING INC.
Entity type:Organization
Organization Name:WELLNESS CENTRUM FAMILY COUNSELING INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:URSULA
Authorized Official - Middle Name:DOROTA
Authorized Official - Last Name:ANTONIK-BUXTON
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:530-721-2255
Mailing Address - Street 1:PO BOX 842
Mailing Address - Street 2:
Mailing Address - City:BELLA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:96008-0842
Mailing Address - Country:US
Mailing Address - Phone:530-721-2255
Mailing Address - Fax:
Practice Address - Street 1:3310 CHURN CREEEK ROAD
Practice Address - Street 2:SUITE A
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96002-9600
Practice Address - Country:US
Practice Address - Phone:530-721-2255
Practice Address - Fax:530-605-3221
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WELLNESS CENTRUM FAMILY COUNSELING INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-01-11
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health