Basic Information
| Provider Information | |||||||||
| NPI: | 1346696176 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | FRANKLIN FAMILY PRACTICE INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2213 GRAND AVE | ||||||||
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| City: | DES MOINES | ||||||||
| State: | IA | ||||||||
| PostalCode: | 503125305 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5152373974 | ||||||||
| FaxNumber: | 5158832692 | ||||||||
| Practice Location | |||||||||
| Address1: | 813 N LINCOLN ST | ||||||||
| Address2: | STE 15 | ||||||||
| City: | KNOXVILLE | ||||||||
| State: | IA | ||||||||
| PostalCode: | 501381421 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5152804930 | ||||||||
| FaxNumber: | 5153090686 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/11/2016 | ||||||||
| LastUpdateDate: | 05/19/2016 | ||||||||
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| AuthorizedOfficialLastName: | POLICH | ||||||||
| AuthorizedOfficialFirstName: | MICHAEL | ||||||||
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| AuthorizedOfficialTitleorPosition: | CHIEF EXECUTIVE OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 5152804930 | ||||||||
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| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | UNITED COMMUNITY SERVICES INC | ||||||||
| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 324500000X | Y | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility |
No ID Information.