Provider Demographics
NPI:1235431719
Name:FAMILY RESOURCE SERVICES LLC
Entity Type:Organization
Organization Name:FAMILY RESOURCE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:HOWARD
Authorized Official - Last Name:KRALL
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW
Authorized Official - Phone:860-933-1604
Mailing Address - Street 1:PO BOX 92
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:CT
Mailing Address - Zip Code:06247
Mailing Address - Country:US
Mailing Address - Phone:860-933-1604
Mailing Address - Fax:860-465-9848
Practice Address - Street 1:33 STATION ROAD
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:CT
Practice Address - Zip Code:06247
Practice Address - Country:US
Practice Address - Phone:860-933-1604
Practice Address - Fax:860-465-9848
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-03
Last Update Date:2010-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty