Provider Demographics
NPI:1750832358
Name:POSITIVE OPTION FAMILY SERVICE
Entity Type:Organization
Organization Name:POSITIVE OPTION FAMILY SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DALE
Authorized Official - Middle Name:
Authorized Official - Last Name:STEVENSON
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:916-973-2838
Mailing Address - Street 1:PO BOX 202
Mailing Address - Street 2:
Mailing Address - City:CITRUS HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:95611-0202
Mailing Address - Country:US
Mailing Address - Phone:916-973-2838
Mailing Address - Fax:916-973-2850
Practice Address - Street 1:2400 GLENDALE LN
Practice Address - Street 2:STE G
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-2431
Practice Address - Country:US
Practice Address - Phone:916-973-2838
Practice Address - Fax:916-973-2850
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-18
Last Update Date:2016-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center