Provider Demographics
NPI:1063784858
Name:FAMILY COMMUNITY RESOURCES
Entity type:Organization
Organization Name:FAMILY COMMUNITY RESOURCES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:LOWE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-500-3464
Mailing Address - Street 1:1203 KENT RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27606-1977
Mailing Address - Country:US
Mailing Address - Phone:919-500-3464
Mailing Address - Fax:
Practice Address - Street 1:2721 VISTA PKWY
Practice Address - Street 2:SUITE C-111
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-6722
Practice Address - Country:US
Practice Address - Phone:919-500-3464
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-08
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health