Provider Demographics
NPI:1073705570
Name:OUR TOWN FAMILY CENTER
Entity Type:Organization
Organization Name:OUR TOWN FAMILY CENTER
Other - Org Name:OUR FAMILY SERVICES, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SUE
Authorized Official - Middle Name:
Authorized Official - Last Name:KRAHE-EGGLESTON
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:520-323-1797
Mailing Address - Street 1:3830 E BELLEVUE ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85716-4012
Mailing Address - Country:US
Mailing Address - Phone:520-323-1708
Mailing Address - Fax:520-323-9077
Practice Address - Street 1:3830 E BELLEVUE ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85716-4012
Practice Address - Country:US
Practice Address - Phone:520-323-1708
Practice Address - Fax:520-323-9077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-17
Last Update Date:2007-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ104618OtherAHCCCCS