Provider Demographics
NPI:1366846016
Name:FAMILY CONNECTIONS, INC.
Entity Type:Organization
Organization Name:FAMILY CONNECTIONS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:E
Authorized Official - Last Name:DOBRZANSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:304-527-3303
Mailing Address - Street 1:PO BOX 348
Mailing Address - Street 2:
Mailing Address - City:COLLIERS
Mailing Address - State:WV
Mailing Address - Zip Code:26035-0348
Mailing Address - Country:US
Mailing Address - Phone:304-527-3303
Mailing Address - Fax:304-527-3306
Practice Address - Street 1:3305 TENT CHURCH ROAD
Practice Address - Street 2:
Practice Address - City:COLLIERS
Practice Address - State:WV
Practice Address - Zip Code:26035
Practice Address - Country:US
Practice Address - Phone:304-527-3303
Practice Address - Fax:304-527-3306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-09
Last Update Date:2014-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV13GR10322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0023528002Medicaid