Organization · NPI-2
Family Service Agency
Community/Behavioral Health · Phoenix, AZ
NPI number1255538732
StatusActive
Last updated in NPPESNov 21, 2023
Details
- NPI
- 1255538732
- Entity type
- Organization (NPI-2)
- Legal business name
- Family Service Agency
- Organization subpart
- No
- Enumeration date
- Jun 28, 2007
- Certification date
- Nov 21, 2023
- Last updated
- Nov 21, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 251S00000X | Community/Behavioral Health | – | – | Yes |
| 251V00000X | Voluntary or Charitable | BH-383 | AZ |
Practice location
10220 N 31st Ave Ste 103-105Phoenix, AZ 85051-9581
Phone 602-863-1862 · Fax 602-863-4388
Mailing address
Po Box 86537Tucson, AZ 85754-6537
Phone 520-721-1887 · Fax 520-721-0069
Authorized official
Rose M Lopez
President And Ceo
5207211887
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