1790818516 NPI number — FAMILY CENTERS INC

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 1790818516 NPI number — FAMILY CENTERS INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FAMILY CENTERS 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:
Provider Other Organization Name Type Code:
6
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:
1790818516
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/02/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
40 ARCH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GREENWICH
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06830-6525
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
203-517-1085
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
888 WASHINGTON BOULEVARD
Provider Second Line Business Practice Location Address:
8TH FLOOR
Provider Business Practice Location Address City Name:
STAMFORD
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06901-2902
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-977-4848
Provider Business Practice Location Address Fax Number:
203-977-4946
Provider Enumeration Date:
03/13/2007

Additional Information

Authorized Official

Authorized Official Last Name:
BEALE
Authorized Official First Name:
MARION
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF FINANCIAL OFFICER
Authorized Official Telephone Number:
203-517-1016

Provider Taxonomy Codes

  • Taxonomy code: 261QH0100X , with the licence number:  0434 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QH0100X , with the licence number: 0152 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QH0100X , with the licence number: 0245 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QH0100X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QH0100X , with the licence number: 0190 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 004142444 , issued by the state of ( CT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 004144482 , issued by the state of ( CT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 004143947 , issued by the state of ( CT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 004143997 , issued by the state of ( CT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 004264248 , issued by the state of ( CT ) . This identifiers is of the category "MEDICAID".




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