Provider Demographics
NPI:1043307432
Name:FAMILY SERVICES OF CENTRAL CONNECTICUT, INC.
Entity Type:Organization
Organization Name:FAMILY SERVICES OF CENTRAL CONNECTICUT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:MURADIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPA
Authorized Official - Phone:860-826-1358
Mailing Address - Street 1:92 VINE ST
Mailing Address - Street 2:
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06052-1433
Mailing Address - Country:US
Mailing Address - Phone:860-223-9291
Mailing Address - Fax:860-223-3111
Practice Address - Street 1:5 COLONY ST
Practice Address - Street 2:SUITES 301 7 303
Practice Address - City:MERIDEN
Practice Address - State:CT
Practice Address - Zip Code:06451-3272
Practice Address - Country:US
Practice Address - Phone:203-235-7923
Practice Address - Fax:203-235-0013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0383261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTANC1482OtherOXFORD HEALTH PLANS
CTCTGA000438 B10006OtherSAGA GRP
CT77ABH0021CT01OtherANTHEM
CTANC1482OtherOXFORD HEALTH PLANS