Organization
FAMILT SUPPORT AGENCY, INC.
Active
Other names
Familt Support Agency
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RYAN LEE LAVINE B.ED., RC (CHIEF EXECUTIVE OFFICER)
(509) 443-4680
Entity
Organization
Contact information
Practice address
208 S DIVISION ST, MOSES LAKE, WA 98837-1954
(509) 350-5260
Mailing address
9 S WASHINGTON ST, SUITE 505, SPOKANE, WA 99201-3719
(509) 443-4680
(877) 280-8502
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
02/03/2010
Last updated
02/03/2010
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