Provider Demographics
NPI:1679320733
Name:FAMILY ADVOCATES FOR INDEPENDENCE AND RESOURCES
Entity type:Organization
Organization Name:FAMILY ADVOCATES FOR INDEPENDENCE AND RESOURCES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:KENNETH
Authorized Official - Last Name:ROTHEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-729-2905
Mailing Address - Street 1:11426 60TH LN N
Mailing Address - Street 2:
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33782-2011
Mailing Address - Country:US
Mailing Address - Phone:727-729-2905
Mailing Address - Fax:
Practice Address - Street 1:11426 60TH LN N
Practice Address - Street 2:
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33782-2011
Practice Address - Country:US
Practice Address - Phone:727-729-2905
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-06
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services