Provider Demographics
NPI:1932325982
Name:FAMILY AND CHILDREN'S THERAPY SERVICES, PA
Entity Type:Organization
Organization Name:FAMILY AND CHILDREN'S THERAPY SERVICES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARLANE
Authorized Official - Middle Name:
Authorized Official - Last Name:GARNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-436-2445
Mailing Address - Street 1:164 N 200 W
Mailing Address - Street 2:
Mailing Address - City:RUPERT
Mailing Address - State:ID
Mailing Address - Zip Code:83350-9357
Mailing Address - Country:US
Mailing Address - Phone:208-436-2445
Mailing Address - Fax:208-434-2445
Practice Address - Street 1:2321 E GALA ST
Practice Address - Street 2:SUITE #3
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642-4881
Practice Address - Country:US
Practice Address - Phone:208-322-4769
Practice Address - Fax:208-322-2498
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health