Provider Demographics
NPI: | 1619011574 |
---|---|
Name: | FAMILY SERVICES OF SOUTHEAST TEXAS INC |
Entity Type: | Organization |
Organization Name: | FAMILY SERVICES OF SOUTHEAST TEXAS INC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | BILLING/CREDENTIAL MANAGER |
Authorized Official - Prefix: | MRS |
Authorized Official - First Name: | SHIRLEY |
Authorized Official - Middle Name: | ANN |
Authorized Official - Last Name: | FIGARI |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 409-833-2668 |
Mailing Address - Street 1: | 3550 FANNIN ST |
Mailing Address - Street 2: | |
Mailing Address - City: | BEAUMONT |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 77701-3805 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 409-833-2668 |
Mailing Address - Fax: | 409-838-2558 |
Practice Address - Street 1: | 3550 FANNIN ST |
Practice Address - Street 2: | |
Practice Address - City: | BEAUMONT |
Practice Address - State: | TX |
Practice Address - Zip Code: | 77701-3805 |
Practice Address - Country: | US |
Practice Address - Phone: | 409-833-2668 |
Practice Address - Fax: | 409-838-2558 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2007-02-16 |
Last Update Date: | 2022-02-08 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | Mental Health | Group - Single Specialty |