Familt Support Agency, Inc.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

FAMILT SUPPORT AGENCY, INC.

Practice address

208 S Division St
Moses Lake, WA 98837-1954

Phone

(509) 350-5260

NPI assigned

Feb 3, 2010

Last updated

Feb 3, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Ryan Lee Lavine, B.ED., RC

Title

Chief Executive Officer

Phone

(509) 443-4680

Specialties & licenses 1

Addresses

Other names 1

• Familt Support Agency Other name

Locations

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

{
    "created_epoch": "1265155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265155200000",
    "number": "1386976280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 S WASHINGTON ST",
            "address_2": "SUITE 505",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992013719",
            "telephone_number": "509-443-4680",
            "fax_number": "877-280-8502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 S DIVISION ST",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "988371954",
            "telephone_number": "509-350-5260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILT SUPPORT AGENCY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-03",
        "last_updated": "2010-02-03",
        "status": "A",
        "authorized_official_last_name": "LAVINE",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "509-443-4680",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "B.ED., RC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Familt Support Agency",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• James Ewell, PHYSICIAN ASSISTANT
• George Kenyon Exeter, PTA
• Emily Fairbanks, MS, RDN, CD
• Vaughn Roger Fairbanks, DC
• Andrea E Falcon, BA
• Family Lifestyle Chiropractic PLLC
• Family Services
• Mindy Farias
• Jose Osvaldo Fariaz
• David Daniel Feller, DDS

• Community/Behavioral Health Agency in Moses Lake, WA
• Providers in Moses Lake, WA by specialty
• Community/Behavioral Health Agency in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2010; 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.