Provider Demographics
NPI:1578719860
Name:FAMILY INTERVENTION & COMMUNITY ADVOCACY
Entity Type:Organization
Organization Name:FAMILY INTERVENTION & COMMUNITY ADVOCACY
Other - Org Name:F.I.C.A., INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:SHEMEIKA
Authorized Official - Middle Name:ANNTOINETTE
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:919-623-4485
Mailing Address - Street 1:301 MCCULLOUGH DR
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262-3310
Mailing Address - Country:US
Mailing Address - Phone:919-623-4485
Mailing Address - Fax:252-793-3117
Practice Address - Street 1:301 MCCULLOUGH DR
Practice Address - Street 2:4TH FLOOR
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-3310
Practice Address - Country:US
Practice Address - Phone:919-623-4485
Practice Address - Fax:252-793-3117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-18
Last Update Date:2009-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251F00000XAgenciesHome Infusion
No252Y00000XAgenciesEarly Intervention Provider Agency