Provider Demographics
NPI:1700050945
Name:FAMILY AND CHILDREN SERVICES OF TROY, INC.
Entity Type:Organization
Organization Name:FAMILY AND CHILDREN SERVICES OF TROY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:GORDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-272-6012
Mailing Address - Street 1:2331 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:NY
Mailing Address - Zip Code:12180-2221
Mailing Address - Country:US
Mailing Address - Phone:518-272-6012
Mailing Address - Fax:
Practice Address - Street 1:2328 5TH AVE
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:NY
Practice Address - Zip Code:12180-2220
Practice Address - Country:US
Practice Address - Phone:518-272-6012
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMMISSION ON ECONOMIC OPPORTUNITY FOR THE GREATER CAPITAL REGION, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-04-18
Last Update Date:2008-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01138105Medicaid