Provider Demographics
NPI:1922027895
Name:FAMILY GUIDANCE CENTER CORPORATION
Entity Type:Organization
Organization Name:FAMILY GUIDANCE CENTER CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT DIRECTOR BHS
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BENEDICT
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:609-587-7044
Mailing Address - Street 1:2300 HAMILTON AVE
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-3007
Mailing Address - Country:US
Mailing Address - Phone:609-587-7044
Mailing Address - Fax:609-587-6765
Practice Address - Street 1:2300 HAMILTON AVE
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08619-3007
Practice Address - Country:US
Practice Address - Phone:609-587-7044
Practice Address - Fax:609-587-6765
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41142261QR0405X
NJ261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Not Answered261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0102709Medicaid
NJ0010138Medicaid
NJ0102709Medicaid