Provider Demographics
NPI:1437534740
Name:THE FAMILY WELLNESS CENTER, INC
Entity Type:Organization
Organization Name:THE FAMILY WELLNESS CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WENDELL
Authorized Official - Middle Name:BRIAN
Authorized Official - Last Name:FALBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-748-5641
Mailing Address - Street 1:2526 PENNSYLVANIA AVE SE STE C
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-6719
Mailing Address - Country:US
Mailing Address - Phone:202-748-5641
Mailing Address - Fax:
Practice Address - Street 1:2526 PENNSYLVANIA AVE SE STE C
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-6719
Practice Address - Country:US
Practice Address - Phone:202-748-5641
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-28
Last Update Date:2015-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC052032100Medicaid