Healthcare Provider Details
I. General information
NPI: 1275654568
Provider Name (Legal Business Name): FAMILY SERVICE ASSOCIATION OF GREATER FALL RIVER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/03/2007
Last Update Date: 01/29/2020
Certification Date: 01/29/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
397 BAY ST
FALL RIVER MA
02724-1513
US
IV. Provider business mailing address
397 BAY ST
FALL RIVER MA
02724-1513
US
V. Phone/Fax
- Phone: 508-646-0135
- Fax: 508-646-0197
- Phone: 508-677-3822
- Fax: 508-679-6129
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA0600X |
| Taxonomy | Adult Day Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
CAROL
A
NAGLE
Title or Position: CEO
Credential: MS
Phone: 508-677-3822