Provider Demographics
NPI:1376672972
Name:THE FAMILY CENTER, INC.
Entity Type:Organization
Organization Name:THE FAMILY CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECTUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:VINES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-628-8815
Mailing Address - Street 1:509 CENTRE ST APT 4
Mailing Address - Street 2:
Mailing Address - City:JAMAICA PLAIN
Mailing Address - State:MA
Mailing Address - Zip Code:02130-2040
Mailing Address - Country:US
Mailing Address - Phone:617-335-1916
Mailing Address - Fax:
Practice Address - Street 1:366 SOMERVILLE AVE
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02143-2919
Practice Address - Country:US
Practice Address - Phone:617-628-8815
Practice Address - Fax:617-625-2351
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA111736251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health