Provider Demographics
NPI:1164638359
Name:FAMILY SERVICES OF TULARE CO.
Entity Type:Organization
Organization Name:FAMILY SERVICES OF TULARE CO.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY ALICE
Authorized Official - Middle Name:
Authorized Official - Last Name:BOYLAN
Authorized Official - Suffix:
Authorized Official - Credentials:MSMFT
Authorized Official - Phone:559-741-7310
Mailing Address - Street 1:815 W OAK AVE
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93291-6033
Mailing Address - Country:US
Mailing Address - Phone:559-741-7310
Mailing Address - Fax:559-732-6404
Practice Address - Street 1:815 W OAK AVE
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93291-6033
Practice Address - Country:US
Practice Address - Phone:559-741-7310
Practice Address - Fax:559-732-6404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251S00000X
251X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251X00000XAgenciesSupports Brokerage
No251S00000XAgenciesCommunity/Behavioral Health