Provider Demographics
NPI:1073887360
Name:FAMILY CENTER FOR BEHAVIORAL HEALTH
Entity Type:Organization
Organization Name:FAMILY CENTER FOR BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROSARIO
Authorized Official - Middle Name:MORILLO
Authorized Official - Last Name:FALERO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:857-334-6348
Mailing Address - Street 1:703 CASWYCK TRCE
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022-4549
Mailing Address - Country:US
Mailing Address - Phone:857-334-6348
Mailing Address - Fax:
Practice Address - Street 1:310 PROSPECT PL
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-5467
Practice Address - Country:US
Practice Address - Phone:857-334-6348
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-04
Last Update Date:2012-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY003521103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty