Organization
FAMILY PREERVATION SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL C FIDGEON (CEO)
(540) 710-3085
Entity
Organization
Contact information
Practice address
800 EUSTACE RD, STAFFORD, VA 22554-3794
(540) 372-1438
(540) 372-7071
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
10/24/2008
Last updated
10/24/2008
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