Provider Demographics
NPI:1093062903
Name:ABOUT FAMILIES, CEDARR
Entity Type:Organization
Organization Name:ABOUT FAMILIES, CEDARR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CANCILLIERE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-365-6855
Mailing Address - Street 1:203 CONCORD ST
Mailing Address - Street 2:SUITE 335
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02860-3477
Mailing Address - Country:US
Mailing Address - Phone:401-365-6855
Mailing Address - Fax:401-365-6860
Practice Address - Street 1:203 CONCORD ST
Practice Address - Street 2:SUITE 335
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860-3477
Practice Address - Country:US
Practice Address - Phone:401-365-6855
Practice Address - Fax:401-365-6860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-09
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RICSW01345251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health