1063654168 NPI number — FAMILY & CHILDREN FIRST, INC.

Table of content: (NPI 1063654168)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063654168 NPI number — FAMILY & CHILDREN FIRST, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FAMILY & CHILDREN FIRST, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
FAMILY & CHILDREN'S PLACE, INC.
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1063654168
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/21/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
525 ZANE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LOUISVILLE
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40203-3203
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
502-893-3900
Provider Business Mailing Address Fax Number:
502-893-3900

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1800 NEVILLE DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOUISVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40216-3820
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-893-3900
Provider Business Practice Location Address Fax Number:
502-893-9646
Provider Enumeration Date:
04/03/2009

Additional Information

Authorized Official

Authorized Official Last Name:
MCQUADE
Authorized Official First Name:
JACK
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR OF FINANCE
Authorized Official Telephone Number:
502-893-3900

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 13000088 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 090217000 . This is a "MAGELLAN" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 000000224164 . This is a "ANTHEM" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 100415400 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".




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