Provider Demographics
NPI:1023438082
Name:FAMILY BEHAVIORAL RESOURCES, INC.
Entity type:Organization
Organization Name:FAMILY BEHAVIORAL RESOURCES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIR OF CLINICAL & BUSINESS SYSTEMS
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIDG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-850-1750
Mailing Address - Street 1:PO BOX 879
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-0879
Mailing Address - Country:US
Mailing Address - Phone:724-850-1750
Mailing Address - Fax:724-420-5318
Practice Address - Street 1:313 W HIGH ST
Practice Address - Street 2:STE 209
Practice Address - City:EBENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15931-1549
Practice Address - Country:US
Practice Address - Phone:814-419-8046
Practice Address - Fax:814-419-8274
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FAMILY BEHAVIORAL RESOURCES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-04-17
Last Update Date:2014-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA422020251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007624160036Medicaid