Provider Demographics
NPI:1871760504
Name:FAMILY RESOURCES
Entity type:Organization
Organization Name:FAMILY RESOURCES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ROBERTA
Authorized Official - Middle Name:
Authorized Official - Last Name:BELL
Authorized Official - Suffix:
Authorized Official - Credentials:MSSW, LCSW
Authorized Official - Phone:608-647-5076
Mailing Address - Street 1:165 N CENTRAL AVE
Mailing Address - Street 2:PO BOX 467
Mailing Address - City:RICHLAND CENTER
Mailing Address - State:WI
Mailing Address - Zip Code:53581-2253
Mailing Address - Country:US
Mailing Address - Phone:608-647-5076
Mailing Address - Fax:608-647-8444
Practice Address - Street 1:165 N CENTRAL AVE
Practice Address - Street 2:SUITE 302,
Practice Address - City:RICHLAND CENTER
Practice Address - State:WI
Practice Address - Zip Code:53581-2253
Practice Address - Country:US
Practice Address - Phone:608-647-5076
Practice Address - Fax:608-647-8444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-12
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2581261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI40929900Medicaid
WI42240300Medicaid