=====================================================
General NPI Number Information
=====================================================
NPI Number | 1336657964
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FAMILIES CARE, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/17/2018
-----------------------------------------------------
Last Update Date | 01/17/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4111 4TH AVE STE 2
-----------------------------------------------------
City | KEARNEY
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68845-2883
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 308-237-1102
-----------------------------------------------------
Fax | 308-237-1102
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4111 4TH AVE STE 2
-----------------------------------------------------
City | KEARNEY
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68845-2883
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 308-237-1102
-----------------------------------------------------
Fax | 308-234-5712
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EXECUTIVE DIRECTOR
-----------------------------------------------------
Name | KARLA S. BENNETTS
-----------------------------------------------------
Credential | CPSP
-----------------------------------------------------
Telephone | 308-237-1102
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------