Provider Demographics
NPI:1700922739
Name:THE FAMILY BONDING CENTER OF THE APPALACHIAN REGION
Entity Type:Organization
Organization Name:THE FAMILY BONDING CENTER OF THE APPALACHIAN REGION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:FAHRINGER
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:865-414-0388
Mailing Address - Street 1:304 TOM FRANKLIN RD
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37760-3510
Mailing Address - Country:US
Mailing Address - Phone:865-414-0388
Mailing Address - Fax:865-475-9409
Practice Address - Street 1:544 N BROADWAY ST
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37917-7406
Practice Address - Country:US
Practice Address - Phone:865-414-0388
Practice Address - Fax:865-475-9409
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNL.M.F.T.#514251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health