Provider Demographics
NPI:1245258722
Name:COVERED BRIDGE FAMILY RESOURCES LLC
Entity type:Organization
Organization Name:COVERED BRIDGE FAMILY RESOURCES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:KRISTIN
Authorized Official - Last Name:SMOTHERS
Authorized Official - Suffix:
Authorized Official - Credentials:MSW LICSW
Authorized Official - Phone:507-732-4136
Mailing Address - Street 1:PO BOX 134
Mailing Address - Street 2:
Mailing Address - City:ZUMBROTA
Mailing Address - State:MN
Mailing Address - Zip Code:55992
Mailing Address - Country:US
Mailing Address - Phone:507-732-4136
Mailing Address - Fax:888-527-4602
Practice Address - Street 1:77 WEST 5TH STREET
Practice Address - Street 2:
Practice Address - City:ZUMBROTA
Practice Address - State:MN
Practice Address - Zip Code:55992
Practice Address - Country:US
Practice Address - Phone:507-732-4136
Practice Address - Fax:888-527-4602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
94362OtherHEALTH PTNRS
560040500OtherMHCPR
131914OtherU CARE
694S3COOtherBCBS