Provider Demographics
NPI:1760298699
Name:CITRUS COUNSELING SERVICES, INC
Entity type:Organization
Organization Name:CITRUS COUNSELING SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:UMINSKI
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:909-793-1078
Mailing Address - Street 1:101 E REDLANDS BLVD STE 215
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-4724
Mailing Address - Country:US
Mailing Address - Phone:909-793-1078
Mailing Address - Fax:
Practice Address - Street 1:23406 CREST FOREST DR.
Practice Address - Street 2:
Practice Address - City:CRESTLINE
Practice Address - State:CA
Practice Address - Zip Code:93225
Practice Address - Country:US
Practice Address - Phone:909-335-4689
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-05
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)