Provider Demographics
NPI:1265649503
Name:FAMILIES UNITED NETWORK
Entity Type:Organization
Organization Name:FAMILIES UNITED NETWORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AGENCY OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LARAINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDONELL
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:208-656-0077
Mailing Address - Street 1:1512 RED CEDAR RD
Mailing Address - Street 2:
Mailing Address - City:REXBURG
Mailing Address - State:ID
Mailing Address - Zip Code:83440
Mailing Address - Country:US
Mailing Address - Phone:208-351-0649
Mailing Address - Fax:208-656-8830
Practice Address - Street 1:1512 RED CEDAR RD
Practice Address - Street 2:
Practice Address - City:REXBURG
Practice Address - State:ID
Practice Address - Zip Code:83440
Practice Address - Country:US
Practice Address - Phone:208-351-0649
Practice Address - Fax:208-656-8830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management