Healthcare Provider Details

I. General information

NPI: 1235271305
Provider Name (Legal Business Name): FAMILY SERVICE'S INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 COURT ST
SIOUX CITY IA
51104-3243
US

IV. Provider business mailing address

PO BOX 1197
SIOUX CITY IA
51102-1197
US

V. Phone/Fax

Practice location:
  • Phone: 712-293-4700
  • Fax: 712-293-4805
Mailing address:
  • Phone: 712-293-4700
  • Fax: 712-293-4805

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. TINA MARIE RENKEN
Title or Position: OUTPATIENT BUSINESS MANAGER
Credential:
Phone: 712-293-4798