Healthcare Provider Details

I. General information

NPI: 1699896993
Provider Name (Legal Business Name): FAMILY SERVICE ASSOCIATION OF GREATER FALL RIVER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 08/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 ROCK STREET FAMILY SERVICE ASSOCIATION ADULT FAMILY CARE
FALL RIVER MA
02720
US

IV. Provider business mailing address

PO BOX 70
FALL RIVER MA
02722-0070
US

V. Phone/Fax

Practice location:
  • Phone: 508-677-3822
  • Fax: 508-677-3714
Mailing address:
  • Phone: 508-677-3822
  • Fax: 508-673-7056

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: MRS. CAROL A NAGLE
Title or Position: CEO
Credential: MS
Phone: 508-677-3822