Provider Demographics
NPI:1134487390
Name:FAMILY AGENDA COMMUNITY CENTER
Entity Type:Organization
Organization Name:FAMILY AGENDA COMMUNITY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR / PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:FRANKLIN
Authorized Official - Last Name:CHILES
Authorized Official - Suffix:
Authorized Official - Credentials:MA (INTERN)
Authorized Official - Phone:504-452-0881
Mailing Address - Street 1:1727 HOLIDAY DR
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70114-3453
Mailing Address - Country:US
Mailing Address - Phone:504-452-0881
Mailing Address - Fax:
Practice Address - Street 1:1727 HOLIDAY DR
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70114-3453
Practice Address - Country:US
Practice Address - Phone:504-452-0881
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-25
Last Update Date:2012-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty