| Family Service Agency | |
|
3342 E Greenway Rd Ste 108 Phoenix AZ 85032-4540 | |
| (602) 275-2726 | |
| (602) 293-3591 |
| Full Name | Family Service Agency |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 3342 E Greenway Rd Ste 108, Phoenix, Arizona |
| Authorized Official Name and Position | Rose M Lopez (PRESIDENT AND CEO) |
| Authorized Official Contact | 5207211887 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Service Agency Po Box 86537 Tucson AZ 85754-6537 Ph: (520) 721-1887 | Family Service Agency 3342 E Greenway Rd Ste 108 Phoenix AZ 85032-4540 Ph: (602) 275-2726 |
| NPI Number | 1477597193 |
|---|---|
| Provider Enumeration Date | 06/15/2006 |
| Last Update Date | 11/21/2023 |
| Certification Date | 11/21/2023 |
| Medicare PECOS PAC ID | 0446443782 |
|---|---|
| Medicare Enrollment ID | O20101019001665 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477597193 | NPI | - | NPPES |
| OTC12977 | Other | AZ | ADHS/BMFL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| 251V00000X | Voluntary Or Charitable | BH-2847 (Arizona) | Secondary |
| Provider Name | Jennifer M Linehan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467547414 PECOS PAC ID: 9436104098 Enrollment ID: I20050316000478 |
| Provider Name | Sangita B Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548662208 PECOS PAC ID: 3375852932 Enrollment ID: I20151021001793 |
| Provider Name | Sarah Manco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396907598 PECOS PAC ID: 3678736238 Enrollment ID: I20160429000909 |
| Provider Name | Toni Antoinette Singer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760864318 PECOS PAC ID: 7911275599 Enrollment ID: I20170922001622 |
| Provider Name | Dumebi Uchendu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558870378 PECOS PAC ID: 0941568240 Enrollment ID: I20171214000901 |
| Provider Name | Margarita Madrid |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619476207 PECOS PAC ID: 6901150028 Enrollment ID: I20181108000733 |
| Provider Name | Delphine Valentin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982205944 PECOS PAC ID: 7618375841 Enrollment ID: I20211001001733 |
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