Healthcare Provider Details

I. General information

NPI: 1588208532
Provider Name (Legal Business Name): FAMILY COMMUNITY SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2019
Last Update Date: 05/12/2020
Certification Date: 05/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

422 W RIVERSIDE AVE STE 330
SPOKANE WA
99201-0307
US

IV. Provider business mailing address

1312 N MONROE ST STE 111
SPOKANE WA
99201-2623
US

V. Phone/Fax

Practice location:
  • Phone: 509-557-0684
  • Fax:
Mailing address:
  • Phone: 509-557-0684
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: RONALD FIECHTNER
Title or Position: TREASURER
Credential: MA
Phone: 408-628-3932