Provider Demographics
NPI:1053780601
Name:FAMILY ASSOCIATION PLUS
Entity type:Organization
Organization Name:FAMILY ASSOCIATION PLUS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:
Authorized Official - Last Name:KELLOGG-WEAVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-473-6420
Mailing Address - Street 1:15746 VINE AVE
Mailing Address - Street 2:
Mailing Address - City:HARVEY
Mailing Address - State:IL
Mailing Address - Zip Code:60426-5040
Mailing Address - Country:US
Mailing Address - Phone:708-473-6420
Mailing Address - Fax:
Practice Address - Street 1:15746 VINE AVE
Practice Address - Street 2:
Practice Address - City:HARVEY
Practice Address - State:IL
Practice Address - Zip Code:60426-5040
Practice Address - Country:US
Practice Address - Phone:708-473-6420
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-24
Last Update Date:2015-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care