Provider Demographics
NPI:1386837490
Name:CENTRO MULTICULTURAL LA FAMILIA, INC
Entity Type:Organization
Organization Name:CENTRO MULTICULTURAL LA FAMILIA, INC
Other - Org Name:MULTICULTURAL FAMILY CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SONIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ACOSTA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:248-858-7800
Mailing Address - Street 1:35 W HURON ST
Mailing Address - Street 2:SUITE 500
Mailing Address - City:PONTIAC
Mailing Address - State:MI
Mailing Address - Zip Code:48342-2120
Mailing Address - Country:US
Mailing Address - Phone:248-858-7800
Mailing Address - Fax:248-874-4830
Practice Address - Street 1:35 W HURON ST
Practice Address - Street 2:SUITE 500
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48342-2120
Practice Address - Country:US
Practice Address - Phone:248-858-7800
Practice Address - Fax:248-874-4830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-22
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261Q00000X, 261QM0801X
MI261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health