Provider Demographics
NPI:1265768907
Name:FAMILY INNOVATIONS
Entity type:Organization
Organization Name:FAMILY INNOVATIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:L
Authorized Official - Last Name:OLIGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-277-0624
Mailing Address - Street 1:715 E 5TH ST
Mailing Address - Street 2:STE 212
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28202-3001
Mailing Address - Country:US
Mailing Address - Phone:704-277-0624
Mailing Address - Fax:
Practice Address - Street 1:715 E 5TH ST
Practice Address - Street 2:STE 212
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28202-3001
Practice Address - Country:US
Practice Address - Phone:704-277-0624
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-31
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health