Provider Demographics
NPI:1396865259
Name:FAMILY ASSOCIATES
Entity Type:Organization
Organization Name:FAMILY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:MANKO
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:401-737-6436
Mailing Address - Street 1:615 JEFFERSON BLVD
Mailing Address - Street 2:SUITE 208B
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-1357
Mailing Address - Country:US
Mailing Address - Phone:401-737-6436
Mailing Address - Fax:401-732-1228
Practice Address - Street 1:615 JEFFERSON BLVD
Practice Address - Street 2:SUITE 208B
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-1357
Practice Address - Country:US
Practice Address - Phone:401-737-6436
Practice Address - Fax:401-732-1228
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI1021900OtherBEACON HEALTH STRATEGIES
RI=========OtherBLUE CHIP
RI=========OtherBLUE CROSS & BLUE SHIELD
RI=========OtherUNITED BEHAVIORAL HEALTH