Provider Demographics
NPI:1609045434
Name:FAMILY SERVICE CENTERS, INC.
Entity Type:Organization
Organization Name:FAMILY SERVICE CENTERS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SERENA
Authorized Official - Middle Name:
Authorized Official - Last Name:BARNES
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:727-489-5243
Mailing Address - Street 1:2960 ROOSEVELT BLVD
Mailing Address - Street 2:ADMIN. BUILDING
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33760-1952
Mailing Address - Country:US
Mailing Address - Phone:727-531-0482
Mailing Address - Fax:727-536-7867
Practice Address - Street 1:2960 ROOSEVELT BLVD
Practice Address - Street 2:ADMIN. BUILDING
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33760-1952
Practice Address - Country:US
Practice Address - Phone:727-531-0482
Practice Address - Fax:727-536-7867
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-26
Last Update Date:2008-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC5519251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL024077001Medicaid