Provider Demographics
NPI:1831593334
Name:FAMILY ADVOCATES, INC
Entity type:Organization
Organization Name:FAMILY ADVOCATES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TCM SUPERVISOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:KYLE
Authorized Official - Last Name:DUNN-CONROW
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:727-201-7979
Mailing Address - Street 1:2601 TECHNOLOGY DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-8003
Mailing Address - Country:US
Mailing Address - Phone:727-201-7979
Mailing Address - Fax:
Practice Address - Street 1:2601 TECHNOLOGY DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-8003
Practice Address - Country:US
Practice Address - Phone:727-201-7979
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-14
Last Update Date:2014-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
No252Y00000XAgenciesEarly Intervention Provider Agency
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1083058010Medicaid