1588268437 NPI number — DEDICATED FAMILY 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 1588268437 NPI number — DEDICATED FAMILY SERVICES LLC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DEDICATED FAMILY 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:
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:
1588268437
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1212 BATH AVE STE 390
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ASHLAND
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
41101-2696
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
606-923-4315
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1212 BATH AVE STE 390
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ASHLAND
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41101-2696
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-923-4315
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/22/2020

Additional Information

Authorized Official

Authorized Official Last Name:
DILLOW
Authorized Official First Name:
MARGIE
Authorized Official Middle Name:
Authorized Official Title or Position:
PROVIDER
Authorized Official Telephone Number:
606-923-4315

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , registered in the state of NULL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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