| Organization Name: | FAMILY AND COMMUNITY THERAPY SERVICES, LLC |
| NPI Number: | 1467895235 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KRISTIN CHARLESWORTH (OWNER) |
| Mailing Address: | 107 Ward Ter Crystal City |
| State: | MO US |
| Postal Code: | 630191707 |
| Phone Number: | 3145465242 |
| Fax Number: | 3142220514 |
| NPI Enumeration Date: | 04/11/2013 |
| NPI Last Update Date: | 04/11/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 2011039647 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |