Provider Demographics
NPI:1316647480
Name:MARRIAGE & FAMILY THERAPY FOR PEACE OF MIND CORPORATION
Entity type:Organization
Organization Name:MARRIAGE & FAMILY THERAPY FOR PEACE OF MIND CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:AUSTIN
Authorized Official - Last Name:NGANGA
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:916-477-4494
Mailing Address - Street 1:3705 DAYTON ST
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95838-3920
Mailing Address - Country:US
Mailing Address - Phone:916-477-4494
Mailing Address - Fax:
Practice Address - Street 1:874 57TH ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95819-3327
Practice Address - Country:US
Practice Address - Phone:916-477-4494
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-07
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty