Provider Demographics
NPI:1710768700
Name:FATHERS BUILDING FUTURES
Entity Type:Organization
Organization Name:FATHERS BUILDING FUTURES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PROGRAM SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:JANESSA
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:TRUJILLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-341-9034
Mailing Address - Street 1:1223 4TH ST NW STE B
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87102-1414
Mailing Address - Country:US
Mailing Address - Phone:505-341-9034
Mailing Address - Fax:
Practice Address - Street 1:1223 4TH ST NW STE B
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-1414
Practice Address - Country:US
Practice Address - Phone:505-341-9034
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-06
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management