Provider Demographics
NPI:1356685143
Name:FAMILY AND COMMUNITY MULTISERVICE AGENCY INC
Entity Type:Organization
Organization Name:FAMILY AND COMMUNITY MULTISERVICE AGENCY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANG
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:718-734-7806
Mailing Address - Street 1:77 NEW AVE
Mailing Address - Street 2:
Mailing Address - City:WYANDANCH
Mailing Address - State:NY
Mailing Address - Zip Code:11798-4318
Mailing Address - Country:US
Mailing Address - Phone:718-734-7806
Mailing Address - Fax:631-253-4525
Practice Address - Street 1:970 WILLIAMS AVE
Practice Address - Street 2:SUITE 3D
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11207-8262
Practice Address - Country:US
Practice Address - Phone:718-734-7806
Practice Address - Fax:631-253-4525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-16
Last Update Date:2012-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health