Provider Demographics
NPI:1437230745
Name:FAMILY MATTERS INSTITUTE, INC.
Entity Type:Organization
Organization Name:FAMILY MATTERS INSTITUTE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:GENEVA
Authorized Official - Middle Name:L
Authorized Official - Last Name:OSAWE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW,LMFT
Authorized Official - Phone:219-980-4330
Mailing Address - Street 1:5825 BROADWAY
Mailing Address - Street 2:SUITE D
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-2687
Mailing Address - Country:US
Mailing Address - Phone:219-980-4330
Mailing Address - Fax:219-980-9119
Practice Address - Street 1:5825 BROADWAY
Practice Address - Street 2:SUITE D
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-2687
Practice Address - Country:US
Practice Address - Phone:219-980-4330
Practice Address - Fax:219-980-9119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN340000011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN9001137OtherBLUE CROSS & SHIELD IL
IN202580Medicare ID - Type Unspecified