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General NPI Number Information
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NPI Number | 1467925420
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Entity Type | Organization
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Legal Business Name | THE FAMILY PLACE D/B/A TFP SERVICES THERAPEUTIC
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Dates
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Enumeration Date | 01/02/2019
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Last Update Date | 01/02/2019
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Provider Practice Location Address
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Address Line | 390 NE 2ND ST.
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City | ONTARIO
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State | OR
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Zip | 97914
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Country | US
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Telephone | 541-889-1050
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Fax | 541-889-6524
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Provider Business Mailing Address
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Address Line | P.O. BOX V, (ONTARIO) 390 NE 2ND ST.
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City | ONTARIO
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State | OR
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Zip | 97914
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Country | US
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Telephone | 541-889-1050
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Fax | 541-889-6524
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Authorized Official
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Title or Position | EXEC DIRECTOR
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Name | MS. TESS D. SHELLENBARGER
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Credential | LCPC(ID), LPC(OR)
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Telephone | 541-889-1050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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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 | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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