Organization
FAMILY PRESERVATION COMMUNITY SERVICES
Active
Parent organization
FAMILY PRESERVATION COMMUNITY SERVICES
Other names
CYS Family Preservation Community Services Wraparound
Organization subpart
Yes
Provider details
NPI number
Legal business name
FAMILY PRESERVATION COMMUNITY SERVICES
Authorized official
THERESA STOLLER LMFT (PROGRAM DIRECTOR)
(714) 399-1860
Entity
Organization
Contact information
Practice address
2112 EAST 4TH STREET, SUITE 107, SANTA ANA, CA 92705
(714) 399-1860
(714) 399-1867
Mailing address
2112 EAST 4TH STREET, SUITE 107, SANTA ANA, CA 92705
(714) 399-1860
(714) 399-1867
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PROVIDER # 30EB
MEDI-CAL
CA
Enumeration date
07/16/2007
Last updated
10/31/2014
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