1043547383 NPI number — FAMILY SOLUTIONS NETWORK, INC.

Table of content: (NPI 1043547383)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043547383 NPI number — FAMILY SOLUTIONS NETWORK, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FAMILY SOLUTIONS NETWORK, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
TURNING WINDS
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1043547383
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/09/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6885 BAUMAN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BONNERS FERRY
Provider Business Mailing Address State Name:
ID
Provider Business Mailing Address Postal Code:
83805-8723
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
208-267-1500
Provider Business Mailing Address Fax Number:
208-267-1600

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
31733 SOUTH FORK RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TROY
Provider Business Practice Location Address State Name:
MT
Provider Business Practice Location Address Postal Code:
59935
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
406-295-5400
Provider Business Practice Location Address Fax Number:
406-295-5420
Provider Enumeration Date:
11/06/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BAISDEN
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
W.
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
208-267-1500

Provider Taxonomy Codes

  • Taxonomy code: 322D00000X , with the licence number:  PAARP 14 , registered in the state of MT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 324500000X , with the licence number: PAARG 14 , registered in the state of MT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)