Healthcare Provider Details

I. General information

NPI: 1356406201
Provider Name (Legal Business Name): FAMILY SERVICE'S INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 FUTURES DR
SOUTH SIOUX CITY NE
68776-3920
US

IV. Provider business mailing address

PO BOX 1197
SIOUX CITY IA
51102-1197
US

V. Phone/Fax

Practice location:
  • Phone: 712-293-4798
  • Fax: 712-293-4805
Mailing address:
  • Phone: 712-293-4798
  • Fax: 712-293-4805

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

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