Provider Demographics
NPI:1437454766
Name:FAMILY, INC
Entity Type:Organization
Organization Name:FAMILY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CONSTANCE
Authorized Official - Middle Name:
Authorized Official - Last Name:GRONSTAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-256-9566
Mailing Address - Street 1:3501 HARRY LANGDON BLVD
Mailing Address - Street 2:STE. 150
Mailing Address - City:COUNCIL BLUFFS
Mailing Address - State:IA
Mailing Address - Zip Code:51503-7837
Mailing Address - Country:US
Mailing Address - Phone:712-256-9566
Mailing Address - Fax:712-256-9916
Practice Address - Street 1:3501 HARRY LANGDON BLVD
Practice Address - Street 2:STE. 150
Practice Address - City:COUNCIL BLUFFS
Practice Address - State:IA
Practice Address - Zip Code:51503-7837
Practice Address - Country:US
Practice Address - Phone:712-256-9566
Practice Address - Fax:712-256-9916
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-18
Last Update Date:2011-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA251K00000X251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare