Provider Demographics
NPI:1780960807
Name:INSTITUTE FOR FAMILY CENTERED SERVICES, INC
Entity type:Organization
Organization Name:INSTITUTE FOR FAMILY CENTERED SERVICES, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP & SR. ASST GENERAL COUNSEL
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:PATRICIA
Authorized Official - Last Name:RODENBERG-ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-836-2234
Mailing Address - Street 1:3210 SKIPWITH RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23294-4443
Mailing Address - Country:US
Mailing Address - Phone:804-346-0051
Mailing Address - Fax:804-346-0494
Practice Address - Street 1:8604 CLIFF CAMERON DR
Practice Address - Street 2:SUITE 170
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28269-8505
Practice Address - Country:US
Practice Address - Phone:704-594-9837
Practice Address - Fax:704-594-9575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-03
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8303414Medicaid