Provider Demographics
NPI:1619933611
Name:FAMILY PRESERVATION CENTER, INC.
Entity Type:Organization
Organization Name:FAMILY PRESERVATION CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:GUERDIE
Authorized Official - Middle Name:D
Authorized Official - Last Name:JOSEPH
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:508-583-6622
Mailing Address - Street 1:33 W ELM ST
Mailing Address - Street 2:
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02301-4317
Mailing Address - Country:US
Mailing Address - Phone:508-583-6622
Mailing Address - Fax:508-583-6656
Practice Address - Street 1:33 W ELM ST
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-4317
Practice Address - Country:US
Practice Address - Phone:508-583-6622
Practice Address - Fax:508-583-6656
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-26
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty