Provider Demographics
NPI:1477608297
Name:INSTITUTE FOR FAMILY CENTERED SERVICES
Entity Type:Organization
Organization Name:INSTITUTE FOR FAMILY CENTERED SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRIANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-346-0051
Mailing Address - Street 1:3210 SKIPWITH RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23294-4443
Mailing Address - Country:US
Mailing Address - Phone:804-346-0051
Mailing Address - Fax:804-346-0494
Practice Address - Street 1:4101 RAVENSWOOD RD
Practice Address - Street 2:SUITE 323
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33312-5373
Practice Address - Country:US
Practice Address - Phone:954-316-4926
Practice Address - Fax:954-316-4921
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2012-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL070614101Medicaid