Provider Demographics
NPI:1013120328
Name:FAMILY INTERVENTION SERVICES INC
Entity Type:Organization
Organization Name:FAMILY INTERVENTION SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:JEANNE
Authorized Official - Middle Name:M
Authorized Official - Last Name:WARNOCK
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:973-275-1570
Mailing Address - Street 1:106 VALLEY ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07079-2886
Mailing Address - Country:US
Mailing Address - Phone:973-275-1570
Mailing Address - Fax:973-275-1568
Practice Address - Street 1:106 VALLEY ST
Practice Address - Street 2:
Practice Address - City:SOUTH ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07079-2886
Practice Address - Country:US
Practice Address - Phone:973-275-1570
Practice Address - Fax:973-275-1568
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0034321Medicaid
NJ0021164Medicaid
NJ0081710Medicaid
NJ0018210Medicaid
NJ0018261Medicaid
NJ0017809Medicaid
NJ0017922Medicaid
NJ0017922Medicaid