1376740480 NPI number — INSTITUTE FOR FAMILY CENTERED SERVICES

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376740480 NPI number — INSTITUTE FOR FAMILY CENTERED SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
INSTITUTE FOR FAMILY CENTERED SERVICES
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:
IFCS
Provider Other Organization Name Type Code:
5
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:
1376740480
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/07/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
313 CONGRESS ST
Provider Second Line Business Mailing Address:
FIFTH FLOOR
Provider Business Mailing Address City Name:
BOSTON
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02210-1218
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
617-790-4800
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7501 FORBES BLVD STE 102
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LANHAM
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20706-6201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-577-7931
Provider Business Practice Location Address Fax Number:
301-577-7637
Provider Enumeration Date:
07/02/2007

Additional Information

Authorized Official

Authorized Official Last Name:
LINDLEY
Authorized Official First Name:
DENISE
Authorized Official Middle Name:
Authorized Official Title or Position:
STATE DIRECTOR
Authorized Official Telephone Number:
410-455-4601

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 590800101 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".




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