Provider Demographics
NPI:1851449532
Name:FAMILY CONNECTIONS
Entity Type:Organization
Organization Name:FAMILY CONNECTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:MEEHAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:505-285-3825
Mailing Address - Street 1:317 W STEPHENS AVE
Mailing Address - Street 2:
Mailing Address - City:GRANTS
Mailing Address - State:NM
Mailing Address - Zip Code:87020-2548
Mailing Address - Country:US
Mailing Address - Phone:505-285-3825
Mailing Address - Fax:
Practice Address - Street 1:317 W STEPHENS AVE
Practice Address - Street 2:
Practice Address - City:GRANTS
Practice Address - State:NM
Practice Address - Zip Code:87020-2548
Practice Address - Country:US
Practice Address - Phone:505-285-3825
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMNM600656OtherVALUEOPTIONS OF NEW MEXIC
NM06321259Medicaid