Provider Demographics
NPI:1710716758
Name:FAMILY SERVICE AIDES LLC
Entity type:Organization
Organization Name:FAMILY SERVICE AIDES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:CERNIGLIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-509-8296
Mailing Address - Street 1:201 W INDIAN SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85013-3203
Mailing Address - Country:US
Mailing Address - Phone:602-795-1170
Mailing Address - Fax:
Practice Address - Street 1:201 W INDIAN SCHOOL RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013-3203
Practice Address - Country:US
Practice Address - Phone:602-795-1170
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-29
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty