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Organization
FAMILY CARE CENTER, INC
Active
Organization
FAMILY CARE CENTER, INC
Active
Other names
FAMILY CARE CENTER, INC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THANA SINGARAJAH LPCP-69 (EXECUTIVE DIRECTOR)
(208) 529-8832
Entity
Organization
Contact information
Practice address
1740 E 17TH ST STE B, IDAHO FALLS, ID 83404-6375
(208) 529-8832
(208) 522-8725
Mailing address
310 N 2ND E STE 114, REXBURG, ID 83440-1606
(208) 359-0581
(208) 359-1125
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010006240
BLUE SHIELD OF IDAHO
ID
01
—
8J513
BLUE CROSS OF IDAHO
ID
Enumeration date
03/15/2007
Last updated
07/21/2022
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