Healthcare Provider Details

I. General information

NPI: 1730500240
Provider Name (Legal Business Name): COMMUNITY AND FAMILY RESOURCES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/31/2013
Last Update Date: 09/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1619 S HIGH AVE
AMES IA
50010-8055
US

IV. Provider business mailing address

211 AVENUE M
FORT DODGE IA
50501-5789
US

V. Phone/Fax

Practice location:
  • Phone: 515-232-3206
  • Fax: 515-232-3780
Mailing address:
  • Phone: 515-576-7261
  • Fax: 515-955-7628

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name: PAM BARKLEY
Title or Position: CONTROLLER
Credential:
Phone: 515-576-7261