Organization
ALLIANCE FAMILY SERVICES NORTH, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACEY LANGE (DIRECTOR)
(208) 265-5049
Entity
Organization
Contact information
Practice address
1101 W MOANA LN, SUITE 14, RENO, NV 89509-4775
(775) 337-2394
Mailing address
608 S DIVISION AVE, SANDPOINT, ID 83864-1749
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
—
106H00000X
Marriage & Family Therapist
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QD1600X
Developmental Disabilities Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100509367
—
NV
05
—
100509368
—
NV
05
—
100511714
—
NV
Enumeration date
04/11/2007
Last updated
02/23/2011
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