Provider Demographics
NPI:1679628028
Name:FAMILY SERVICE
Entity Type:Organization
Organization Name:FAMILY SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:PEKAR
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:609-267-5928
Mailing Address - Street 1:770 WOODLANE RD
Mailing Address - Street 2:SUITE 63
Mailing Address - City:WESTAMPTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08060-3806
Mailing Address - Country:US
Mailing Address - Phone:609-267-5928
Mailing Address - Fax:609-267-4842
Practice Address - Street 1:770 WOODLANE RD
Practice Address - Street 2:SUITE 57
Practice Address - City:WESTAMPTON
Practice Address - State:NJ
Practice Address - Zip Code:08060-3806
Practice Address - Country:US
Practice Address - Phone:609-518-2477
Practice Address - Fax:609-518-2472
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0020320Medicaid