Provider Demographics
NPI:1326341165
Name:FAMILY PRESERVATION SERVICES
Entity Type:Organization
Organization Name:FAMILY PRESERVATION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TARGETED CASE MANAGER SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:PAULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCLAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-264-8152
Mailing Address - Street 1:1731 NW 6TH ST STE I
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32609-8515
Mailing Address - Country:US
Mailing Address - Phone:352-264-8152
Mailing Address - Fax:
Practice Address - Street 1:1731 NW 6TH ST STE I
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32609-8515
Practice Address - Country:US
Practice Address - Phone:352-264-8152
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-17
Last Update Date:2010-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health