Provider Demographics
NPI:1063528560
Name:FAMILY PRESERVATION SERVICES OF FLORIDA, LLC
Entity type:Organization
Organization Name:FAMILY PRESERVATION SERVICES OF FLORIDA, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:REGIONAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOYD
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC, NCC
Authorized Official - Phone:504-250-7655
Mailing Address - Street 1:3925 N I 10 SERVICE RD W STE 117
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-6831
Mailing Address - Country:US
Mailing Address - Phone:504-455-2446
Mailing Address - Fax:504-455-7626
Practice Address - Street 1:3925 N I 10 SERVICE RD W STE 117
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-6831
Practice Address - Country:US
Practice Address - Phone:504-455-2446
Practice Address - Fax:504-455-7626
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-21
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL070609403Medicaid
FL760557900Medicaid
FL760557902Medicaid
FL766141000Medicaid
FL001567600Medicaid
FL070892501Medicaid
FL001568900Medicaid
FL070863100Medicaid
FL001568800Medicaid
FL070604300Medicaid
FL070609400Medicaid
FL070863103Medicaid
FL070604300Medicaid
FL760557900Medicaid