Provider Demographics
NPI:1275708893
Name:FIGHTING BACK PARTNERSHIP
Entity Type:Organization
Organization Name:FIGHTING BACK PARTNERSHIP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FRC DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOSEPHINE
Authorized Official - Middle Name:J
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-648-5230
Mailing Address - Street 1:505 SANTA CLARA ST
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94590
Mailing Address - Country:US
Mailing Address - Phone:707-648-5230
Mailing Address - Fax:707-648-5212
Practice Address - Street 1:505 SANTA CLARA ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94590-5922
Practice Address - Country:US
Practice Address - Phone:707-648-5230
Practice Address - Fax:707-648-5212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-24
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management