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NPI Code Detail

MEDICARE: FAMILY PRESERVATION SERVICES

MEDICARE: FAMILY PRESERVATION SERVICES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorSW7040FL

General Provider Information

NPI Number : 1942403217
Entity Type Code : Organization
Provider Name (Legal Business Name) : FAMILY PRESERVATION SERVICES
Provider Business Mailing Address
First Line : 1316 PATTON AVE STE D
Second Line :
City : ASHEVILLE
State : NC
Zip : 28806-2652
Country : US
Telephone Number : 828-225-3100
Fax Number :
Provider Business Practice Location Address
First Line : 690 FRIDAY RD
Second Line :
City : COCOA
State : FL
Zip : 32926-3317
Country : US
Telephone Number : 321-636-9941
Fax Number : 321-636-0915
Authorized Official
Title or Position : OFFICE MANAGER
Name : MRS. CRYSTAL SIMPSON
Credential :
Telephone Number : 828-225-3100
Provider Enumeration Date : 06/06/2007
Last Update Date : 09/16/2013

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Directions to “FAMILY PRESERVATION SERVICES ” Practice Location

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