Provider Demographics
NPI:1528339074
Name:FAMILY CONNECTION
Entity type:Organization
Organization Name:FAMILY CONNECTION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DANNA
Authorized Official - Middle Name:JANELL
Authorized Official - Last Name:FISHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-274-6555
Mailing Address - Street 1:1121 CUMMINGS DR
Mailing Address - Street 2:
Mailing Address - City:BOULDER CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89005-3136
Mailing Address - Country:US
Mailing Address - Phone:702-274-6555
Mailing Address - Fax:
Practice Address - Street 1:1121 CUMMINGS DR
Practice Address - Street 2:
Practice Address - City:BOULDER CITY
Practice Address - State:NV
Practice Address - Zip Code:89005-3136
Practice Address - Country:US
Practice Address - Phone:702-274-6555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-14
Last Update Date:2012-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty