Provider Demographics
NPI:1144372319
Name:CHRISTIAN FAMILY CARE AGENCY
Entity type:Organization
Organization Name:CHRISTIAN FAMILY CARE AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP PROGRAMS-SOUTHERN AZ
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAM
Authorized Official - Middle Name:
Authorized Official - Last Name:GIARDINA
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC
Authorized Official - Phone:520-296-8255
Mailing Address - Street 1:6063 E GRANT RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-2318
Mailing Address - Country:US
Mailing Address - Phone:520-296-8255
Mailing Address - Fax:520-296-8773
Practice Address - Street 1:6063 E GRANT RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-2318
Practice Address - Country:US
Practice Address - Phone:520-296-8255
Practice Address - Fax:520-296-8773
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW-11535104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty