Provider Demographics
NPI:1841231677
Name:FAMILY SERVICE ASSOCIATION OF MONROE COUNTY
Entity Type:Organization
Organization Name:FAMILY SERVICE ASSOCIATION OF MONROE COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAVES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-339-1551
Mailing Address - Street 1:120 W 7TH ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47404-3834
Mailing Address - Country:US
Mailing Address - Phone:812-339-1551
Mailing Address - Fax:812-334-8398
Practice Address - Street 1:120 W 7TH ST
Practice Address - Street 2:SUITE 104
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47404-3834
Practice Address - Country:US
Practice Address - Phone:812-339-1551
Practice Address - Fax:812-334-8398
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty