Provider Demographics
NPI:1306154281
Name:FAMILY VIOLENCE PREVENTION SERVICES, INC.
Entity type:Organization
Organization Name:FAMILY VIOLENCE PREVENTION SERVICES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:MARTA
Authorized Official - Middle Name:B
Authorized Official - Last Name:PELAEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:210-930-3669
Mailing Address - Street 1:7911 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78209-2601
Mailing Address - Country:US
Mailing Address - Phone:210-930-3669
Mailing Address - Fax:210-821-6194
Practice Address - Street 1:7911 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209-2601
Practice Address - Country:US
Practice Address - Phone:210-930-3669
Practice Address - Fax:210-821-6194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-14
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18659101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty