MEDICARE: FAMILY BUILDERS FOSTER CARE AGENCY, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1134346927
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY BUILDERS FOSTER CARE AGENCY, INC

Provider Business Mailing Address
First Line	:	2499 W SHAW AVE
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93711-3329
Country	:	US
Telephone Number	:	559-248-0395
Fax Number	:

Provider Business Practice Location Address
First Line	:	2499 W SHAW AVE
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93711-3329
Country	:	US
Telephone Number	:	559-248-0395
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MS. RAMONA CHADWELL
Credential	:	MSW
Telephone Number	:	559-636-1775

Provider Enumeration Date	:	04/20/2007
Last Update Date	:	08/11/2008

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