Provider Demographics
NPI:1982269809
Name:WINGS OF COURAGE FAMILY SERVICES COUNSELING & PRESENTATIONS, INC.
Entity Type:Organization
Organization Name:WINGS OF COURAGE FAMILY SERVICES COUNSELING & PRESENTATIONS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:ARMENDARIZ
Authorized Official - Last Name:CORONA
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:909-225-0188
Mailing Address - Street 1:3056 ROCKY LN
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91761-5074
Mailing Address - Country:US
Mailing Address - Phone:909-225-0188
Mailing Address - Fax:909-364-1040
Practice Address - Street 1:4413 RIVERSIDE DR STE F
Practice Address - Street 2:
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710-3949
Practice Address - Country:US
Practice Address - Phone:909-225-0188
Practice Address - Fax:909-364-1040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-06
Last Update Date:2019-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1720124787OtherINDIVIDUAL NPI