Provider Demographics
NPI:1609283894
Name:FAMILY AND CHILDREN EMPOWERMENT THERAPY SERVICES
Entity Type:Organization
Organization Name:FAMILY AND CHILDREN EMPOWERMENT THERAPY SERVICES
Other - Org Name:FACETS
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRACHA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAUM
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:732-626-0484
Mailing Address - Street 1:304 TWIN OAKS DR
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-7155
Mailing Address - Country:US
Mailing Address - Phone:732-626-0484
Mailing Address - Fax:732-626-0484
Practice Address - Street 1:304 TWIN OAKS DR
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-7155
Practice Address - Country:US
Practice Address - Phone:732-626-0484
Practice Address - Fax:732-626-0484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-20
Last Update Date:2014-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC053480001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty