Provider Demographics
NPI:1023771110
Name:TRUE CONNECTIONS OF SOUTHERN CALIFORNIA, LLC
Entity type:Organization
Organization Name:TRUE CONNECTIONS OF SOUTHERN CALIFORNIA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:DVORAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:213-275-6786
Mailing Address - Street 1:23502 MAGIC MOUNTAIN PKWY APT 1511
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-1312
Mailing Address - Country:US
Mailing Address - Phone:213-275-6786
Mailing Address - Fax:
Practice Address - Street 1:23502 MAGIC MOUNTAIN PKWY APT 1511
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-1312
Practice Address - Country:US
Practice Address - Phone:213-275-6786
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-16
Last Update Date:2021-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty