Provider Demographics
NPI:1639690837
Name:INCLUSION FAMILY COUNSELING CENTER INC
Entity Type:Organization
Organization Name:INCLUSION FAMILY COUNSELING CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ADRIANO
Authorized Official - Middle Name:
Authorized Official - Last Name:CABRAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-577-6434
Mailing Address - Street 1:1 CENTRE ST STE 301
Mailing Address - Street 2:
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02301-4095
Mailing Address - Country:US
Mailing Address - Phone:508-510-4483
Mailing Address - Fax:508-857-3817
Practice Address - Street 1:1 CENTRE ST STE 301
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-4095
Practice Address - Country:US
Practice Address - Phone:508-510-4483
Practice Address - Fax:508-857-3817
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1184947657OtherNPI