Provider Demographics
NPI:1083003677
Name:FAMILY & FRIENDS TOGETHER, INC
Entity Type:Organization
Organization Name:FAMILY & FRIENDS TOGETHER, INC
Other - Org Name:FAMILY & FRIENDS TOGETHER DBA FULLEN ENTERPRISES, LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:FULLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-694-9649
Mailing Address - Street 1:PO BOX 750
Mailing Address - Street 2:
Mailing Address - City:YOUNGTOWN
Mailing Address - State:AZ
Mailing Address - Zip Code:85363-9998
Mailing Address - Country:US
Mailing Address - Phone:602-694-9649
Mailing Address - Fax:623-977-3374
Practice Address - Street 1:1195 S 5TH AVE
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-3839
Practice Address - Country:US
Practice Address - Phone:602-694-9649
Practice Address - Fax:623-977-3374
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-20
Last Update Date:2015-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZCSA14ADHS0215 1251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health