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General NPI Number Information
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NPI Number | 1093111205
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Entity Type | Organization
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Legal Business Name | FAMILY THERAPY & RECOVERY P.S.
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Dates
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Enumeration Date | 11/16/2014
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Last Update Date | 08/30/2023
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Provider Practice Location Address
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Address Line | 615 N 2ND ST
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City | TACOMA
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State | WA
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Zip | 98403-2232
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Country | US
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Telephone | 253-220-9452
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Fax | 253-270-2236
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Provider Business Mailing Address
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Address Line | PO BOX 8610
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City | TACOMA
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State | WA
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Zip | 98419-0610
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Country | US
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Telephone | 253-202-9452
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Fax | 253-270-2236
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. PAUL HUNZIKER
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Credential |
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Telephone | 253-208-6393
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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