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General NPI Number Information
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NPI Number | 1679796007
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Entity Type | Organization
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Legal Business Name | ALLIANCE FAMILY SERVICES NORTH, INC.
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Dates
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Enumeration Date | 04/11/2007
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Last Update Date | 02/23/2011
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Provider Practice Location Address
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Address Line | 1101 W MOANA LN SUITE 14
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City | RENO
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State | NV
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Zip | 89509-4775
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Country | US
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Telephone | 775-337-2394
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Fax |
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Provider Business Mailing Address
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Address Line | 608 S DIVISION AVE
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City | SANDPOINT
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State | ID
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Zip | 83864-1749
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | TRACEY LANGE
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Credential |
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Telephone | 208-265-5049
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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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 | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QD1600X
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Taxonomy Name | Developmental Disabilities Clinic/Center
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License Number |
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License Number State |
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Taxonomy #6
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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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Taxonomy #7
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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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