MEDICARE: FAMILY CARE NETWORK, 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	:	1881893295
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY CARE NETWORK, INC.

Provider Business Mailing Address
First Line	:	1255 KENDALL RD
Second Line	:
City	:	SAN LUIS OBISPO
State	:	CA
Zip	:	93401-1577
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 HIGH SCHOOL HILL RD
Second Line	:
City	:	ATASCADERO
State	:	CA
Zip	:	93422-4189
Country	:	US
Telephone Number	:	805-781-3535
Fax Number	:

Authorized Official
Title or Position	:	CEO-EXECUTIVE DIRECTOR
Name	:	JAMES ROBERTS
Credential	:
Telephone Number	:	805-781-3535

Provider Enumeration Date	:	07/16/2007
Last Update Date	:	12/05/2013

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