Provider Demographics
NPI:1255515441
Name:ALLIANCE FAMILY SERVICES NORTH, INC
Entity type:Organization
Organization Name:ALLIANCE FAMILY SERVICES NORTH, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAID BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:FRYTHE
Authorized Official - Middle Name:
Authorized Official - Last Name:SPALDING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-265-5049
Mailing Address - Street 1:608 S DIVISION AVE
Mailing Address - Street 2:
Mailing Address - City:SANDPOINT
Mailing Address - State:ID
Mailing Address - Zip Code:83864-1749
Mailing Address - Country:US
Mailing Address - Phone:208-265-5049
Mailing Address - Fax:208-263-7515
Practice Address - Street 1:1101 W MOANA LN
Practice Address - Street 2:SUITE 2
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-4775
Practice Address - Country:US
Practice Address - Phone:775-337-2394
Practice Address - Fax:775-337-9570
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health