Provider Demographics
NPI:1558522391
Name:ADMECO FAMILY SERVICES
Entity Type:Organization
Organization Name:ADMECO FAMILY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:GENDREAU
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC,CEAP,LADC,CADAC
Authorized Official - Phone:508-347-5403
Mailing Address - Street 1:35 MAIN ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:STURBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:01566-1245
Mailing Address - Country:US
Mailing Address - Phone:877-347-5403
Mailing Address - Fax:413-245-6816
Practice Address - Street 1:35 MAIN ST
Practice Address - Street 2:SUITE B
Practice Address - City:STURBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:01566-1245
Practice Address - Country:US
Practice Address - Phone:877-347-5403
Practice Address - Fax:413-245-6816
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-24
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6609251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA6609OtherLMHC