Provider Demographics
NPI:1336168350
Name:RURAL FAMILY THERAPY SERVICES L.L.C.
Entity type:Organization
Organization Name:RURAL FAMILY THERAPY SERVICES L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:BENSKY
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:641-347-5060
Mailing Address - Street 1:PO BOX 361
Mailing Address - Street 2:
Mailing Address - City:AFTON
Mailing Address - State:IA
Mailing Address - Zip Code:50830-0361
Mailing Address - Country:US
Mailing Address - Phone:641-347-5060
Mailing Address - Fax:641-347-5060
Practice Address - Street 1:505 E TAYLOR ST
Practice Address - Street 2:
Practice Address - City:CRESTON
Practice Address - State:IA
Practice Address - Zip Code:50801-4057
Practice Address - Country:US
Practice Address - Phone:641-782-7212
Practice Address - Fax:641-347-5060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA012221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA01199OtherBC/BS PROVIDER NUMBER
IA0010215Medicaid