Organization
FAMILY RESOURCE CENTERS OF AMERICA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL K BARTELL (OWNER)
(208) 552-1222
Entity
Organization
Contact information
Practice address
2647 E 14 N, IDAHO FALLS, ID 83401-2301
(208) 552-1222
Mailing address
2647 E 14 N, IDAHO FALLS, ID 83401-2301
(208) 552-1222
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
805253400
—
ID
05
—
805384500
—
ID
Enumeration date
08/31/2006
Last updated
03/04/2016
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