| Family Service Agency | |
|
1107 S Gilbert Rd Suite 104 Mesa AZ 85204-5232 | |
| (602) 264-9891 | |
| (602) 234-2639 |
| Full Name | Family Service Agency |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1107 S Gilbert Rd, Mesa, Arizona |
| Authorized Official Name and Position | Rose M Lopez (PRESIDENT AND CEO) |
| Authorized Official Contact | 5207211887 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Service Agency Po Box 86537 Tucson AZ 85754-6537 Ph: (520) 721-1887 | Family Service Agency 1107 S Gilbert Rd Suite 104 Mesa AZ 85204-5232 Ph: (602) 264-9891 |
| NPI Number | 1740487222 |
|---|---|
| Provider Enumeration Date | 06/28/2007 |
| Last Update Date | 11/21/2023 |
| Certification Date | 11/21/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740487222 | NPI | - | NPPES |
| OTC11459 | Other | AZ | ADHS/BMFL |
| 117079 | Other | AZ | AHCCCS |
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