Organization Name: | FAMILY ADVOCACY RESOURCES |
NPI Number: | 1215084454 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CHARLES WILKINSON (ADMINISTRATOR) |
Mailing Address: | 124 South Main Woodward |
State: | IA US |
Postal Code: | 50276 |
Phone Number: | 5154384214 |
Fax Number: | 5154384217 |
NPI Enumeration Date: | 01/03/2007 |
NPI Last Update Date: | 04/20/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 02516 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |