Gateway Counseling Center, Inc. | |
12712 Heacock St Ste 6 Moreno Valley CA 92553-3037 | |
(951) 768-1535 | |
(866) 896-6067 |
Full Name | Gateway Counseling Center, Inc. |
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Speciality | Marriage & Family Therapist |
Location | 12712 Heacock St Ste 6, Moreno Valley, California |
Authorized Official Name and Position | Jack Lawrence Johnson (PRESIDENT) |
Authorized Official Contact | 9517681535 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Gateway Counseling Center, Inc. 3576 Arlington Ave Ste 307 Riverside CA 92506-3988 Ph: (951) 768-1535 | Gateway Counseling Center, Inc. 12712 Heacock St Ste 6 Moreno Valley CA 92553-3037 Ph: (951) 768-1535 |
NPI Number | 1255449708 |
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Provider Enumeration Date | 08/25/2006 |
Last Update Date | 03/11/2010 |
Identifier | Type | State | Issuer |
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1255449708 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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106H00000X | Marriage & Family Therapist | MFC-24968 (California) | Primary |
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