Provider Demographics
NPI:1831202621
Name:FAMILY RESOURCES ASSOCIATES INC
Entity type:Organization
Organization Name:FAMILY RESOURCES ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NIKKI
Authorized Official - Middle Name:L
Authorized Official - Last Name:KUEFFER
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:920-261-4100
Mailing Address - Street 1:PO BOX 364
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:WI
Mailing Address - Zip Code:53094-0364
Mailing Address - Country:US
Mailing Address - Phone:920-261-4100
Mailing Address - Fax:920-261-8801
Practice Address - Street 1:1315 W MAIN ST
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:WI
Practice Address - Zip Code:53094-3564
Practice Address - Country:US
Practice Address - Phone:920-261-4100
Practice Address - Fax:920-261-8801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-16
Last Update Date:2016-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1326101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI68376OtherWPPN MULTIPLAN
WI28146151OtherWAUSAU BENEFITS
WI326643OtherVALUE OPTIONS
WI546292OtherDEAN HEALTH INS
WI215861OtherMHN
WI42177600Medicaid
WI=========013OtherANTHEM BCBS
WI=========013OtherANTHEM BCBS