Provider Demographics
NPI:1851602023
Name:FAMILY BEHAVIORAL RESOURCES
Entity Type:Organization
Organization Name:FAMILY BEHAVIORAL RESOURCES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OUTPATIENT THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:GRANT
Authorized Official - Middle Name:J
Authorized Official - Last Name:KISSEL
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:724-335-9733
Mailing Address - Street 1:3 KENSINGTON SQUARE
Mailing Address - Street 2:SUITE B
Mailing Address - City:NEW KENSINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15068
Mailing Address - Country:US
Mailing Address - Phone:724-335-9733
Mailing Address - Fax:724-335-9734
Practice Address - Street 1:3 KENSINGTON SQ
Practice Address - Street 2:SUITE B
Practice Address - City:NEW KENSINGTON
Practice Address - State:PA
Practice Address - Zip Code:15068-6443
Practice Address - Country:US
Practice Address - Phone:724-335-9733
Practice Address - Fax:724-335-9734
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-23
Last Update Date:2010-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA330989OtherVBH
PA1000364OtherCCBHO
PA206234OtherUPMC
PA424947OtherHEALTH AMERICA
PA1508933599Medicaid
PA184265OtherUNISON