Provider Demographics
NPI:1750681607
Name:FAMILY SERVICES, PLLC
Entity Type:Organization
Organization Name:FAMILY SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:M
Authorized Official - Last Name:PALLER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:208-365-2525
Mailing Address - Street 1:PO BOX 981
Mailing Address - Street 2:
Mailing Address - City:EMMETT
Mailing Address - State:ID
Mailing Address - Zip Code:83617-0981
Mailing Address - Country:US
Mailing Address - Phone:208-365-2525
Mailing Address - Fax:208-365-2234
Practice Address - Street 1:501 N 16TH ST STE 108
Practice Address - Street 2:
Practice Address - City:PAYETTE
Practice Address - State:ID
Practice Address - Zip Code:83661-2782
Practice Address - Country:US
Practice Address - Phone:208-642-6160
Practice Address - Fax:208-642-6171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-26
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty