1346867413 NPI number — FAMILY PRESERVATION SERVICES, LLC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346867413 NPI number — FAMILY PRESERVATION SERVICES, LLC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FAMILY PRESERVATION SERVICES, LLC.
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:
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:
1346867413
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/06/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5371 PETERS CREEK RD NW
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROANOKE
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
24019-3849
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
200 SWAN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BERRYVILLE
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22611-1220
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-535-0043
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/06/2020

Additional Information

Authorized Official

Authorized Official Last Name:
PARITI
Authorized Official First Name:
LISA
Authorized Official Middle Name:
CAROL
Authorized Official Title or Position:
BUSINESS DEVELOPMENT MANAGER
Authorized Official Telephone Number:
682-888-2724

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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