Provider Demographics
NPI:1164543302
Name:FAMILY SERVICE ASSOCIATION OF GREATER FALL RIVER, INC.
Entity Type:Organization
Organization Name:FAMILY SERVICE ASSOCIATION OF GREATER FALL RIVER, INC.
Other - Org Name:FAMILY SERVICE ASSOCIATION COUNTRYSIDE ADULT DAY HEALTH
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:A
Authorized Official - Last Name:NAGLE
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:508-677-3822
Mailing Address - Street 1:101 ROCK ST FL 1
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02720-3138
Mailing Address - Country:US
Mailing Address - Phone:508-677-3822
Mailing Address - Fax:508-673-7056
Practice Address - Street 1:244 N MAIN ST
Practice Address - Street 2:
Practice Address - City:RAYNHAM
Practice Address - State:MA
Practice Address - Zip Code:02767-1686
Practice Address - Country:US
Practice Address - Phone:508-822-6603
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FAMILY SERVICE ASSOCIATION OF GREATER FALL RIVER, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-04-03
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Not Answered374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1900293Medicaid