Provider Demographics
NPI:1144379264
Name:FAMILY CRISIS CENTER INC.
Entity Type:Organization
Organization Name:FAMILY CRISIS CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:OPAL
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:COLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-325-3549
Mailing Address - Street 1:208 E APACHE ST
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:NM
Mailing Address - Zip Code:87401-6904
Mailing Address - Country:US
Mailing Address - Phone:505-325-3549
Mailing Address - Fax:505-325-7803
Practice Address - Street 1:208 E APACHE ST
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:NM
Practice Address - Zip Code:87401-6904
Practice Address - Country:US
Practice Address - Phone:505-325-3549
Practice Address - Fax:505-325-7803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2009-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health