MEDICARE: FAMILY RESOURCES, 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		FL

General Provider Information

NPI Number	:	1689949190
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY RESOURCES, INC.

Provider Business Mailing Address
First Line	:	2286 WEDNESDAY ST STE 1
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32308-8310
Country	:	US
Telephone Number	:	850-222-5511
Fax Number	:	850-298-8857

Provider Business Practice Location Address
First Line	:	2286 WEDNESDAY ST STE 1
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32308-8310
Country	:	US
Telephone Number	:	850-222-5511
Fax Number	:	850-298-8857

Authorized Official
Title or Position	:	PRESIDENT
Name	:	LAURA CLEVENGER
Credential	:
Telephone Number	:	850-222-5511

Provider Enumeration Date	:	03/16/2012
Last Update Date	:	03/16/2012

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