Provider Demographics
NPI:1851788277
Name:P6 FAMILY SERVICES LLC
Entity Type:Organization
Organization Name:P6 FAMILY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINEA
Authorized Official - Middle Name:MOALA
Authorized Official - Last Name:POUONO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-417-1626
Mailing Address - Street 1:2200 NORTH D'ANDREA PKWY #2411
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89434
Mailing Address - Country:US
Mailing Address - Phone:559-417-1626
Mailing Address - Fax:
Practice Address - Street 1:2200 NORTH D'ANDREA PKWY #2411
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89434
Practice Address - Country:US
Practice Address - Phone:559-417-1626
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-23
Last Update Date:2015-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV20151126835251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management