=====================================================
General NPI Number Information
=====================================================
NPI Number | 1043446909
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FAMILY AND COMMUNITY EDUCATION & SUPPORT, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/05/2009
-----------------------------------------------------
Last Update Date | 06/05/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3801 E FLORIDA AVE STE 715
-----------------------------------------------------
City | DENVER
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80210-2543
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 720-570-9333
-----------------------------------------------------
Fax | 720-570-9339
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3801 E FLORIDA AVE STE 715
-----------------------------------------------------
City | DENVER
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80210-2543
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 720-570-9333
-----------------------------------------------------
Fax | 720-570-9339
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EXECUTIVE DIRECTOR
-----------------------------------------------------
Name | DEBORA JUDISH
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 720-570-9333
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251V00000X
-----------------------------------------------------
Taxonomy Name | Voluntary or Charitable Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------