Provider Demographics
NPI:1356190961
Name:FAMILY RESOURCE & REFERRAL CENTER OF SAN JOAQUIN
Entity type:Organization
Organization Name:FAMILY RESOURCE & REFERRAL CENTER OF SAN JOAQUIN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KAY
Authorized Official - Middle Name:G
Authorized Official - Last Name:RUHSTALLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-461-2996
Mailing Address - Street 1:3127 TRANSWORLD DR STE 100
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95206-5003
Mailing Address - Country:US
Mailing Address - Phone:209-461-2998
Mailing Address - Fax:209-461-2998
Practice Address - Street 1:3127 TRANSWORLD DR STE 100
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95206-5003
Practice Address - Country:US
Practice Address - Phone:209-461-2998
Practice Address - Fax:209-461-2998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-15
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management