Provider Demographics
NPI:1154611226
Name:FAMILY PRESERVATION SERVICES
Entity type:Organization
Organization Name:FAMILY PRESERVATION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TARGETED CASE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:ASHLYN
Authorized Official - Last Name:COVERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-260-9812
Mailing Address - Street 1:2051 DR MARTIN LUTHER KING JR BLVD
Mailing Address - Street 2:101
Mailing Address - City:RIVIERA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33404-7004
Mailing Address - Country:US
Mailing Address - Phone:561-683-4778
Mailing Address - Fax:
Practice Address - Street 1:2051 DR MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:101
Practice Address - City:RIVIERA BEACH
Practice Address - State:FL
Practice Address - Zip Code:33404-7004
Practice Address - Country:US
Practice Address - Phone:561-683-4778
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-11
Last Update Date:2011-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management