Provider Demographics
NPI:1972808871
Name:FAMILY PRESERVATION SERVICES
Entity Type:Organization
Organization Name:FAMILY PRESERVATION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICIAN
Authorized Official - Prefix:MISS
Authorized Official - First Name:JOY
Authorized Official - Middle Name:S
Authorized Official - Last Name:SANTOS
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:813-451-1100
Mailing Address - Street 1:11428 N 53RD ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33617-2216
Mailing Address - Country:US
Mailing Address - Phone:813-374-9416
Mailing Address - Fax:
Practice Address - Street 1:11428 N 53RD ST
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33617-2216
Practice Address - Country:US
Practice Address - Phone:813-374-9416
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PROVIDENCE SERVICE CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-01-24
Last Update Date:2011-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health