1083003677 NPI number — FAMILY & FRIENDS TOGETHER, INC

Table of content: (NPI 1083003677)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083003677 NPI number — FAMILY & FRIENDS TOGETHER, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FAMILY & FRIENDS TOGETHER, 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:
Provider Other Organization Name Type Code:
6
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:
1083003677
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/20/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 750
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
YOUNGTOWN
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85363-9998
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
602-694-9649
Provider Business Mailing Address Fax Number:
623-977-3374

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1195 S 5TH AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
YUMA
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85364-3839
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
602-694-9649
Provider Business Practice Location Address Fax Number:
623-977-3374
Provider Enumeration Date:
01/20/2015

Additional Information

Authorized Official

Authorized Official Last Name:
FULLEN
Authorized Official First Name:
CYNTHIA
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
602-694-9649

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , with the licence number:  CSA14ADHS0215 1 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com