Provider Demographics
NPI:1942405576
Name:FAMILY THERAPY SERVICES INC.
Entity Type:Organization
Organization Name:FAMILY THERAPY SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:TETRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-648-0312
Mailing Address - Street 1:70 2ND ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:BROOKVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15825-1509
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:70 2ND ST
Practice Address - Street 2:SUITE C
Practice Address - City:BROOKVILLE
Practice Address - State:PA
Practice Address - Zip Code:15825-1509
Practice Address - Country:US
Practice Address - Phone:814-648-0312
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-14
Last Update Date:2008-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPENDING251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health