1144341421 NPI number — FAMILY & CHILDREN'S AGENCY, 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 1144341421 NPI number — FAMILY & CHILDREN'S AGENCY, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FAMILY & CHILDREN'S AGENCY, 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:
PROJECT REWARD
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:
1144341421
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/07/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9 MOTT AVE
Provider Second Line Business Mailing Address:
4TH FLOOR
Provider Business Mailing Address City Name:
NORWALK
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06850-3330
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
203-855-8765
Provider Business Mailing Address Fax Number:
203-838-3325

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9 MOTT AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORWALK
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06850-3330
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-855-8765
Provider Business Practice Location Address Fax Number:
203-838-3325
Provider Enumeration Date:
04/03/2007

Additional Information

Authorized Official

Authorized Official Last Name:
CASHEL
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
F
Authorized Official Title or Position:
PRESIDENT & CEO
Authorized Official Telephone Number:
203-855-8765

Provider Taxonomy Codes

  • Taxonomy code: 261QM0850X , with the licence number:  0322 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QR0405X , with the licence number: SA-0137 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 291961 . This is a "MHN PROVIDER NUMBER" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 004175106 , issued by the state of ( CT ) . This identifiers is of the category "MEDICAID".
  • Identifier: ANC1195 . This is a "OXFORD BEHAVIORAL HEALTH" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: CTGA000498 . This is a "DMHAS PROVIDER NUMBER" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".




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