Provider Demographics
NPI:1578090379
Name:FAMILY CENTERED TREATMENT FOUNDATION, INC.
Entity Type:Organization
Organization Name:FAMILY CENTERED TREATMENT FOUNDATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TIM
Authorized Official - Middle Name:
Authorized Official - Last Name:WOOD
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:704-787-6869
Mailing Address - Street 1:10140 THOMAS PAYNE CIR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-8822
Mailing Address - Country:US
Mailing Address - Phone:704-787-6869
Mailing Address - Fax:888-316-9747
Practice Address - Street 1:10140 THOMAS PAYNE CIR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-8822
Practice Address - Country:US
Practice Address - Phone:704-787-6869
Practice Address - Fax:888-316-9747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
No251S00000XAgenciesCommunity/Behavioral Health