Provider Demographics
NPI:1891097879
Name:FAMILY PSYCHIATRIC SERVICES, LLC
Entity Type:Organization
Organization Name:FAMILY PSYCHIATRIC SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:TRACI
Authorized Official - Middle Name:
Authorized Official - Last Name:MARANDO
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:203-747-5282
Mailing Address - Street 1:800 VILLAGE WALK STE 241
Mailing Address - Street 2:
Mailing Address - City:GUILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06437-2762
Mailing Address - Country:US
Mailing Address - Phone:203-747-5282
Mailing Address - Fax:203-230-1102
Practice Address - Street 1:800 VILLAGE WALK STE 241
Practice Address - Street 2:
Practice Address - City:GUILFORD
Practice Address - State:CT
Practice Address - Zip Code:06437-2762
Practice Address - Country:US
Practice Address - Phone:203-747-5282
Practice Address - Fax:203-230-1102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-24
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health