1396063624 NPI number — FAMILY SOLUTIONS SERVICES 1, INC.

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 1396063624 NPI number — FAMILY SOLUTIONS SERVICES 1, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FAMILY SOLUTIONS SERVICES 1, 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:
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:
1396063624
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/11/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
209 1ST ST NE
Provider Second Line Business Mailing Address:
#105 PO BOX 258
Provider Business Mailing Address City Name:
ORANGE CITY
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
51041-1456
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
712-707-9222
Provider Business Mailing Address Fax Number:
712-707-9220

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
209 1ST ST NE
Provider Second Line Business Practice Location Address:
#105
Provider Business Practice Location Address City Name:
ORANGE CITY
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
51041-1456
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
712-707-9222
Provider Business Practice Location Address Fax Number:
712-707-9220
Provider Enumeration Date:
05/11/2010

Additional Information

Authorized Official

Authorized Official Last Name:
DRIESEN
Authorized Official First Name:
DENISE
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
712-541-0107

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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