Provider Demographics
NPI:1417937210
Name:FAMILY GUIDANCE CENTER OF WARREN COUNTY
Entity Type:Organization
Organization Name:FAMILY GUIDANCE CENTER OF WARREN COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:
Authorized Official - Last Name:EICHORN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, LCADC
Authorized Official - Phone:908-689-1000
Mailing Address - Street 1:492 ROUTE 57 W
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07882
Mailing Address - Country:US
Mailing Address - Phone:908-689-1000
Mailing Address - Fax:908-689-4529
Practice Address - Street 1:492 ROUTE 57 W
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07882-4338
Practice Address - Country:US
Practice Address - Phone:908-689-1000
Practice Address - Fax:908-689-4529
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-18
Last Update Date:2018-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1050103041261QM0801X
NJ105010104261QM0801X
NJ105010204A261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2317354000OtherAMERIHEALTH
NJ0015202Medicaid
NJ1076761OtherHORIZON MERCY
NJ0100307Medicaid
NJ144238000OtherMAGELLAN
NJ664655Medicare PIN
NJ526270Medicare PIN