Provider Demographics
NPI:1851574941
Name:FAMILY RESOURCE CENTER
Entity Type:Organization
Organization Name:FAMILY RESOURCE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADVOCATE
Authorized Official - Prefix:
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-542-0740
Mailing Address - Street 1:3501 SPRUCE AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:SOUTH LAKE TAHOE
Mailing Address - State:CA
Mailing Address - Zip Code:96150-8317
Mailing Address - Country:US
Mailing Address - Phone:530-542-0740
Mailing Address - Fax:530-542-0397
Practice Address - Street 1:3501 SPRUCE AVE
Practice Address - Street 2:SUITE B
Practice Address - City:SOUTH LAKE TAHOE
Practice Address - State:CA
Practice Address - Zip Code:96150-8317
Practice Address - Country:US
Practice Address - Phone:530-542-0740
Practice Address - Fax:530-542-0397
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-11
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NONE251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health