Provider Demographics
NPI:1023465481
Name:FAMILY INSTITUTE FOR HEALTH AND RECOVERY
Entity type:Organization
Organization Name:FAMILY INSTITUTE FOR HEALTH AND RECOVERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BYNUM
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:602-327-8375
Mailing Address - Street 1:1550 E UNIVERSITY DR
Mailing Address - Street 2:SUITE G
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85203-8136
Mailing Address - Country:US
Mailing Address - Phone:602-327-8375
Mailing Address - Fax:602-926-0590
Practice Address - Street 1:5306 N 17TH AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85015-3035
Practice Address - Country:US
Practice Address - Phone:602-327-8375
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DESTINY SOBER LIVING
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-05-16
Last Update Date:2016-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health