Provider Demographics
NPI:1164115630
Name:TOTAL CARE FAMILY CENTER
Entity Type:Organization
Organization Name:TOTAL CARE FAMILY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:MRS
Authorized Official - First Name:FARIBA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRADY
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:973-919-0652
Mailing Address - Street 1:2141 ACADEMY CIR STE 103
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909-1672
Mailing Address - Country:US
Mailing Address - Phone:973-919-0652
Mailing Address - Fax:
Practice Address - Street 1:2141 ACADEMY CIR STE 103
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-1672
Practice Address - Country:US
Practice Address - Phone:973-919-0652
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-31
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty