Provider Demographics
NPI:1255003596
Name:FAMILY VILLIAGE COUNSELING CENTER LLC
Entity Type:Organization
Organization Name:FAMILY VILLIAGE COUNSELING CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROMEO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-395-1545
Mailing Address - Street 1:187 ASH RPDS
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40511-9173
Mailing Address - Country:US
Mailing Address - Phone:717-395-1545
Mailing Address - Fax:
Practice Address - Street 1:187 ASH RPDS
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40511-9173
Practice Address - Country:US
Practice Address - Phone:717-395-1545
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-05
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty