Provider Demographics
NPI:1366507790
Name:COMMUNITY AND FAMILY RESOURCES
Entity Type:Organization
Organization Name:COMMUNITY AND FAMILY RESOURCES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:MS
Authorized Official - First Name:PAM
Authorized Official - Middle Name:
Authorized Official - Last Name:BARKELY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-576-7261
Mailing Address - Street 1:211 AVENUE M
Mailing Address - Street 2:
Mailing Address - City:FORT DODGE
Mailing Address - State:IA
Mailing Address - Zip Code:50501-5789
Mailing Address - Country:US
Mailing Address - Phone:515-576-7261
Mailing Address - Fax:515-955-7628
Practice Address - Street 1:211 AVENUE M
Practice Address - Street 2:
Practice Address - City:FORT DODGE
Practice Address - State:IA
Practice Address - Zip Code:50501-5789
Practice Address - Country:US
Practice Address - Phone:515-576-7261
Practice Address - Fax:515-955-7628
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-26
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA1254324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility