| Avant Garde Foster Family Agency | |
|
1655 E 6th St Suite A 4-c Corona CA 92879-1732 | |
| (951) 735-5300 | |
| (951) 735-9335 |
| Full Name | Avant Garde Foster Family Agency |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 1655 E 6th St, Corona, California |
| Authorized Official Name and Position | Gregory Estravit (CEO) |
| Authorized Official Contact | 9517355300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Avant Garde Foster Family Agency 1655 E 6th St Suite A 4-d Corona CA 92879-1732 Ph: (951) 735-5300 | Avant Garde Foster Family Agency 1655 E 6th St Suite A 4-c Corona CA 92879-1732 Ph: (951) 735-5300 |
| NPI Number | 1518383983 |
|---|---|
| Provider Enumeration Date | 03/10/2014 |
| Last Update Date | 12/02/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518383983 | NPI | - | NPPES |
| C2552459 | Other | CA | BUSINESS LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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