Organization Active NPI

Family Preservation Services, Inc

  • Community/Behavioral Health Agency
  • Crewe, VA
National Provider Identifier
1053558759
Registry record updated Jan 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
158 02 029 Issued in VA
Legal business name
FAMILY PRESERVATION SERVICES, INC
Practice address
5285 Old Nottoway Rd
Crewe, VA 23930-3636
Phone
(434) 696-4633
Fax
(434) 696-4634
NPI assigned
Jan 16, 2009
Last updated
Jan 16, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Michael C Fidgeon
Title
Coo
Phone
(540) 710-6085

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 158 02 029 VA Primary

Addresses

Primary practice location

5285 Old Nottoway Rd
Crewe, VA 23930-3636

Mailing address

10304 Spotsylvania Ave
3Rd Floor
Fredericksburg, VA 22408-8602
Phone (540) 710-6085

Other identifiers 1

IdentifierTypeStateIssuer
158 02 029MedicaidVA

National Provider Directory

National Provider Directory
Tax ID family
Family Preservation Services Inc134 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 22

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 22

Locations

5285 Old Nottoway Rd
Crewe, VA 23930

10304 Spotsylvania Ave
Fl 3
Fredericksburg, VA 22408
Phone (540) 710-6085

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1232064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1232064000000",
    "number": "1053558759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10304 SPOTSYLVANIA AVE",
            "address_2": "3RD FLOOR",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224088602",
            "telephone_number": "540-710-6085",
            "fax_number": "540-710-6447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5285 OLD NOTTOWAY RD",
            "city": "CREWE",
            "state": "VA",
            "postal_code": "239303636",
            "telephone_number": "434-696-4633",
            "fax_number": "434-696-4634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY PRESERVATION SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-16",
        "last_updated": "2009-01-16",
        "status": "A",
        "authorized_official_last_name": "FIDGEON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "540-710-6085",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "VA",
            "license": "158 02 029",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "158 02 029",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crewe, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.