Provider Demographics
NPI:1396866992
Name:FAMILY SERVICE ASSOCIATION OF GREATER FALL RIVER
Entity Type:Organization
Organization Name:FAMILY SERVICE ASSOCIATION OF GREATER FALL RIVER
Other - Org Name:FAMILY SERVICE ASSOCIATION HOME ASSISTANCE PROGRAM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:A
Authorized Official - Last Name:NAGLE
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:508-677-3822
Mailing Address - Street 1:PO BOX 70
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02722-0070
Mailing Address - Country:US
Mailing Address - Phone:508-677-3822
Mailing Address - Fax:508-673-7056
Practice Address - Street 1:101 ROCK ST
Practice Address - Street 2:2ND FLOOR HOME ASSISTANCE PROGRAM
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-3133
Practice Address - Country:US
Practice Address - Phone:508-677-3822
Practice Address - Fax:508-676-1640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered163WC0400XNursing Service ProvidersRegistered NurseCase ManagementGroup - Multi-Specialty
Not Answered374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1900633Medicaid