Organization
FAMILY PRESERVATION SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL C FIDGEON (PRESIDENT)
(540) 710-6085
Entity
Organization
Contact information
Practice address
130 GROVER CLEVELAND LN, GATE CITY, VA 24251-5716
(276) 431-7214
(276) 431-7215
Mailing address
10304 SPOTSYLVANIA AVE, 3RD FLOOR, FREDERICKSBURG, VA 22408-8602
(540) 710-6085
(540) 710-6447
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
158 02 029
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
158 02 029
—
VA
Enumeration date
06/17/2009
Last updated
06/17/2009
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