Family Based Therapy Associates
NPI #1891100293 in Chisago City, Minnesota
Provider Information
- NPI Number
- 1891100293
- Entity Type
- Organization
- Organization Name
- Family Based Therapy Associates
- Primary Specialty
- Community/Behavioral Health
- Enumeration Date
- Jun 24, 2014
- Last Updated
- Jun 24, 2014
Practice Location
- Address
- 11549 LAKE LN
- Address 2
- SUITE 2
- City
- Chisago City
- State
- Minnesota
- ZIP Code
- 55013-9830
- Phone
- (651) 257-2733
Authorized Official
- Name
- RANDALL WALLACE, LP
- Title
- DIRECTOR
- Phone
- (763) 780-1520
Specialties & Taxonomy Codes
| Specialty |
|---|
| Community/Behavioral Health |
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