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General NPI Number Information
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NPI Number | 1912005059
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Entity Type | Organization
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Legal Business Name | A FAMILY TYME COUNSELING CENTERS
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 06/13/2008
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Provider Practice Location Address
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Address Line | 4070 BRIDGE ST #1
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City | FAIR OAKS
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State | CA
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Zip | 95628-7557
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Country | US
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Telephone | 916-966-4198
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Fax |
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Provider Business Mailing Address
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Address Line | 4070 BRIDGE ST #1
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City | FAIR OAKS
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State | CA
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Zip | 95628-7557
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Country | US
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Telephone | 916-966-4198
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RIAN W SMITH
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Credential |
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Telephone | 916-966-4198
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number | 38147
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License Number State | CA
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