Provider Demographics
NPI:1477519288
Name:FAMILY ENRICHMENT CENTER, INC
Entity Type:Organization
Organization Name:FAMILY ENRICHMENT CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:B
Authorized Official - Last Name:MATTHEWS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:570-342-4665
Mailing Address - Street 1:329 PENN AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18503-1248
Mailing Address - Country:US
Mailing Address - Phone:570-342-4665
Mailing Address - Fax:570-342-5024
Practice Address - Street 1:329 PENN AVE STE 202
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18503-1248
Practice Address - Country:US
Practice Address - Phone:570-342-4665
Practice Address - Fax:570-342-5024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-21
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0015367200003OtherPROMISE