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General NPI Number Information
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NPI Number | 1851574941
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Entity Type | Organization
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Legal Business Name | FAMILY RESOURCE CENTER
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Dates
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Enumeration Date | 12/11/2007
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Last Update Date | 12/11/2007
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Provider Practice Location Address
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Address Line | 3501 SPRUCE AVE SUITE B
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City | SOUTH LAKE TAHOE
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State | CA
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Zip | 96150-8317
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Country | US
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Telephone | 530-542-0740
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Fax | 530-542-0397
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Provider Business Mailing Address
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Address Line | 3501 SPRUCE AVE SUITE B
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City | SOUTH LAKE TAHOE
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State | CA
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Zip | 96150-8317
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Country | US
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Telephone | 530-542-0740
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Fax | 530-542-0397
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Authorized Official
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Title or Position | ADVOCATE
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Name | MARTHA GARCIA
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Credential |
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Telephone | 530-542-0740
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | NONE
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License Number State |
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