Provider Demographics
NPI:1972011096
Name:C.O.P.E. FAMILY SUPPORT CENTER
Entity Type:Organization
Organization Name:C.O.P.E. FAMILY SUPPORT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MISTY
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-689-5811
Mailing Address - Street 1:2280 DIAMOND BLVD STE 460
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-8109
Mailing Address - Country:US
Mailing Address - Phone:925-689-5811
Mailing Address - Fax:925-689-5831
Practice Address - Street 1:3000 CITRUS CIR STE 220
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-2665
Practice Address - Country:US
Practice Address - Phone:925-689-5811
Practice Address - Fax:925-689-5831
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-11
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No251S00000XAgenciesCommunity/Behavioral Health