Provider Demographics
NPI:1770024465
Name:FAMILY RESOURCE ASSOCIATES, INC.
Entity Type:Organization
Organization Name:FAMILY RESOURCE ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:PHALANUKORN
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:732-747-5310
Mailing Address - Street 1:210 NEWMAN SPRINGS RD E
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-1439
Mailing Address - Country:US
Mailing Address - Phone:732-747-5310
Mailing Address - Fax:732-747-1896
Practice Address - Street 1:210 NEWMAN SPRINGS RD E
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-1439
Practice Address - Country:US
Practice Address - Phone:732-747-5310
Practice Address - Fax:732-747-1896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-14
Last Update Date:2018-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1083858575Medicaid