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General NPI Number Information
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NPI Number | 1235431719
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Entity Type | Organization
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Legal Business Name | FAMILY RESOURCE SERVICES LLC
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Dates
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Enumeration Date | 12/03/2010
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Last Update Date | 12/03/2010
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Provider Practice Location Address
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Address Line | 33 STATION ROAD
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City | HAMPTON
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State | CT
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Zip | 06247
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Country | US
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Telephone | 860-933-1604
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Fax | 860-465-9848
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Provider Business Mailing Address
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Address Line | PO BOX 92
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City | HAMPTON
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State | CT
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Zip | 06247
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Country | US
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Telephone | 860-933-1604
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Fax | 860-465-9848
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Authorized Official
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Title or Position | LICENSED CLINICAL SOCIAL WORKER
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Name | MR. JAMES HOWARD KRALL
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Credential | MSW, LCSW
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Telephone | 860-933-1604
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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