Healthcare Provider Details

I. General information

NPI: 1760837942
Provider Name (Legal Business Name): FAMILY BUILDERS FOSTER CARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2016
Last Update Date: 04/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 W. LACEY BLVD SUITE 1B
HANFORD CA
93230
US

IV. Provider business mailing address

520 W LACEY BLVD STE 1B
HANFORD CA
93230-4496
US

V. Phone/Fax

Practice location:
  • Phone: 559-410-8302
  • Fax: 559-410-8612
Mailing address:
  • Phone: 559-410-8302
  • Fax: 559-410-8612

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MONA CHADWELL
Title or Position: EXECUTIVE DIRECTOR
Credential: MSW
Phone: 559-685-1200