Healthcare Provider Details

I. General information

NPI: 1083858575
Provider Name (Legal Business Name): FAMILY RESOURCE ASSOCIATES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2009
Last Update Date: 10/30/2024
Certification Date: 10/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 NEWMAN SPRINGS RD E
RED BANK NJ
07701-1439
US

IV. Provider business mailing address

210 NEWMAN SPRINGS RD E
RED BANK NJ
07701-1439
US

V. Phone/Fax

Practice location:
  • Phone: 732-948-5793
  • Fax: 732-747-1896
Mailing address:
  • Phone: 732-747-5310
  • Fax: 732-747-1896

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code261QA3000X
TaxonomyAugmentative Communication Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. NANCY PHALANUKORN
Title or Position: EXECUTIVE DIRECTOR
Credential: M.A.
Phone: 732-747-5310