Provider Demographics
NPI:1972685774
Name:CENTER FOR CHILD & FAMILY SERVICES INC
Entity Type:Organization
Organization Name:CENTER FOR CHILD & FAMILY SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:EDMONDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-838-1960
Mailing Address - Street 1:739 THIMBLE SHOALS BLVD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-3562
Mailing Address - Country:US
Mailing Address - Phone:757-838-1960
Mailing Address - Fax:757-838-3280
Practice Address - Street 1:739 THIMBLE SHOALS BLVD
Practice Address - Street 2:SUITE 400
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-3562
Practice Address - Country:US
Practice Address - Phone:757-838-1960
Practice Address - Fax:757-838-3280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA545547828OtherTRICARE
VA545547828OtherTRICARE