| Family And Community Resources, Inc. | |
|
18 Newton St Brockton MA 02301-5115 | |
| (508) 583-6498 | |
| (508) 583-3775 |
| Full Name | Family And Community Resources, Inc. |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 18 Newton St, Brockton, Massachusetts |
| Authorized Official Name and Position | Claudette Kelly (BILLING DIRECTOR) |
| Authorized Official Contact | 5085836498 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family And Community Resources, Inc. 18 Newton St Brockton MA 02301-5115 Ph: (508) 583-6498 | Family And Community Resources, Inc. 18 Newton St Brockton MA 02301-5115 Ph: (508) 583-6498 |
| NPI Number | 1821159880 |
|---|---|
| Provider Enumeration Date | 12/13/2006 |
| Last Update Date | 02/10/2020 |
| Certification Date | 02/10/2020 |
| Medicare PECOS PAC ID | 2860489960 |
|---|---|
| Medicare Enrollment ID | O20040429000980 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821159880 | NPI | - | NPPES |
| 1302981 | Other | MD | MBHP ID # |
| 95074701 | Other | MA | NETWORK HEALTH |
| 1302981 | Medicaid | MA | |
| 725287 | Other | MA | TUFTS ID NUMBER |
| M18532 | Other | MA | BCBS ID NUMBER |
| 1003790 | Other | MA | BEACON HEALTH ID # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 4695 DPH (Massachusetts) | Primary |
| Provider Name | Erin K Deehan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205166832 PECOS PAC ID: 2567365919 Enrollment ID: I20040202000029 |
| Provider Name | Ruth E Zakarian |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023158946 PECOS PAC ID: 3971524679 Enrollment ID: I20051209000103 |
| Provider Name | Melissa Gardner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033652987 PECOS PAC ID: 2062796758 Enrollment ID: I20170223002477 |
| Provider Name | Ryan M Lydon |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1669813085 PECOS PAC ID: 9133410038 Enrollment ID: I20170905001355 |
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