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General NPI Number Information
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NPI Number | 1346341427
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Entity Type | Organization
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Legal Business Name | FAMILY SOLUTIONS
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Dates
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Enumeration Date | 09/25/2006
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Last Update Date | 11/29/2023
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Provider Practice Location Address
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Address Line | 201 W MAIN ST STE 4B
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City | MEDFORD
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State | OR
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Zip | 97501-2734
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Country | US
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Telephone | 541-414-1720
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Fax | 541-414-1724
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Provider Business Mailing Address
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Address Line | 1836 FREMONT ST
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City | ASHLAND
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State | OR
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Zip | 97520-2537
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Country | US
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Telephone | 541-414-1720
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Fax | 541-414-1724
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DOROTHY J PROVENCIO
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Credential |
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Telephone | 541-414-1720
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 323P00000X
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Taxonomy Name | Psychiatric Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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