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General NPI Number Information
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NPI Number | 1932499738
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Entity Type | Organization
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Legal Business Name | ALLIANCE FAMILY SERVICES
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Dates
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Enumeration Date | 04/13/2011
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Last Update Date | 04/13/2011
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Provider Practice Location Address
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Address Line | 186 E MAIN ST STE 4
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City | FERNLEY
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State | NV
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Zip | 89408-7717
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Country | US
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Telephone | 775-575-9889
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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 | 208-265-8195
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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 | 208-265-8195
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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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 #3
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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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 | 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 #5
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Taxonomy Code | 261Q00000X
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Taxonomy Name | 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 | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/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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