Provider Demographics
NPI:1255845988
Name:FRIENDS FOR SURVIVAL
Entity Type:Organization
Organization Name:FRIENDS FOR SURVIVAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:
Authorized Official - Last Name:KOENIG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-392-0664
Mailing Address - Street 1:PO BOX 214463
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95821-0463
Mailing Address - Country:US
Mailing Address - Phone:916-392-0664
Mailing Address - Fax:
Practice Address - Street 1:2628 EL CAMINO AVE STE D1
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95821-5936
Practice Address - Country:US
Practice Address - Phone:916-392-0664
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-16
Last Update Date:2017-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare