Provider Demographics
NPI:1972025237
Name:NORTH COUNTY LESBIAN GAY BISEXUAL TRANSGENDER QUESTIONING RESOURCE CEN
Entity type:Organization
Organization Name:NORTH COUNTY LESBIAN GAY BISEXUAL TRANSGENDER QUESTIONING RESOURCE CEN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MAX
Authorized Official - Middle Name:
Authorized Official - Last Name:DISPOSTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-672-1848
Mailing Address - Street 1:3220 MISSION AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92058-1354
Mailing Address - Country:US
Mailing Address - Phone:760-672-1848
Mailing Address - Fax:
Practice Address - Street 1:3220 MISSION AVE STE 2
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92058-1354
Practice Address - Country:US
Practice Address - Phone:760-672-1848
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty