Provider Demographics
NPI:1902353220
Name:BURNETT COUNTY FAMILY RESOURCE CENTER, INC.
Entity Type:Organization
Organization Name:BURNETT COUNTY FAMILY RESOURCE CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-349-2922
Mailing Address - Street 1:PO BOX 139
Mailing Address - Street 2:
Mailing Address - City:SIREN
Mailing Address - State:WI
Mailing Address - Zip Code:54872-0139
Mailing Address - Country:US
Mailing Address - Phone:715-349-2922
Mailing Address - Fax:715-349-5331
Practice Address - Street 1:24062 STATE ROAD 35/70
Practice Address - Street 2:
Practice Address - City:SIREN
Practice Address - State:WI
Practice Address - Zip Code:54872-0139
Practice Address - Country:US
Practice Address - Phone:715-349-2922
Practice Address - Fax:715-349-5331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-02
Last Update Date:2016-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management