Provider Demographics
NPI:1477261113
Name:SUMMERS MARRIAGE & FAMILY THERAPY, INC.
Entity type:Organization
Organization Name:SUMMERS MARRIAGE & FAMILY THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:SUMMERS
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:951-777-9798
Mailing Address - Street 1:2621 GREEN RIVER RD # 105-151
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92882-7433
Mailing Address - Country:US
Mailing Address - Phone:951-777-9798
Mailing Address - Fax:
Practice Address - Street 1:4181 FLAT ROCK DR STE 302
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92505-7106
Practice Address - Country:US
Practice Address - Phone:909-777-9798
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-11
Last Update Date:2022-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty