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NPI Code Detail

MEDICARE: FAMILY SERVICE AGENCY

MEDICARE: FAMILY SERVICE AGENCY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251V00000XVoluntary or Charitable AgencyBH-383AZ
2251S00000XCommunity/Behavioral Health Agency

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1BH4241-OTC8910OTHERAZADHS/BMFL
2117178OTHERAZAHCCCS

General Provider Information

NPI Number : 1255538732
Entity Type Code : Organization
Provider Name (Legal Business Name) : FAMILY SERVICE AGENCY
Provider Business Mailing Address
First Line : PO BOX 86537
Second Line :
City : TUCSON
State : AZ
Zip : 85754-6537
Country : US
Telephone Number : 520-721-1887
Fax Number : 520-721-0069
Provider Business Practice Location Address
First Line : 10220 N 31ST AVE STE 103-105
Second Line :
City : PHOENIX
State : AZ
Zip : 85051-9581
Country : US
Telephone Number : 602-863-1862
Fax Number : 602-863-4388
Authorized Official
Title or Position : PRESIDENT AND CEO
Name : ROSE M LOPEZ
Credential : MBA
Telephone Number : 520-721-1887
Provider Enumeration Date : 06/28/2007
Last Update Date : 11/21/2023

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1407845233 — MR. THOMAS WILLIAM CALLAHAN MSW
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1558352310 — HEIDI H HOWARD LCSW
Practice Location Address:
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1184924904 — ARASH ZAMANIAN M.D.
Practice Location Address:
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Practice Fax: 602-997-2667

Directions to “FAMILY SERVICE AGENCY ” Practice Location

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