Provider Demographics
NPI:1134326143
Name:FAMILY AND COMMUNITY RESOURCES, INC
Entity Type:Organization
Organization Name:FAMILY AND COMMUNITY RESOURCES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:KIMYATTA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:252-753-5100
Mailing Address - Street 1:PO BOX 4204
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27836-2204
Mailing Address - Country:US
Mailing Address - Phone:252-753-5100
Mailing Address - Fax:
Practice Address - Street 1:3707 N MAIN ST
Practice Address - Street 2:SUITE H
Practice Address - City:FARMVILLE
Practice Address - State:NC
Practice Address - Zip Code:27828-1486
Practice Address - Country:US
Practice Address - Phone:252-753-5100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-02
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management