Provider Demographics
NPI:1538670542
Name:FAMILY INTERVENTION SERVICES INC
Entity Type:Organization
Organization Name:FAMILY INTERVENTION SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTANT
Authorized Official - Prefix:
Authorized Official - First Name:MAKRAM
Authorized Official - Middle Name:
Authorized Official - Last Name:MESEHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-324-7879
Mailing Address - Street 1:86 S HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:EAST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07018-1748
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:655 BROADWAY
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07514-1923
Practice Address - Country:US
Practice Address - Phone:973-523-0089
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-17
Last Update Date:2017-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty