Provider Demographics
NPI:1912412172
Name:TCFWC - THE CHILD AND FAMILY WELLNESS CENTER LLC
Entity Type:Organization
Organization Name:TCFWC - THE CHILD AND FAMILY WELLNESS CENTER LLC
Other - Org Name:THE CHILD AND FAMILY WELLNESS CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER, DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:EDWINNA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:WYNN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-763-7272
Mailing Address - Street 1:695 TRUMAN PARKWAY
Mailing Address - Street 2:SUITE #201-202
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02136
Mailing Address - Country:US
Mailing Address - Phone:888-763-7272
Mailing Address - Fax:877-243-2959
Practice Address - Street 1:695 TRUMAN PARKWAY
Practice Address - Street 2:SUITE #201-202
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02136
Practice Address - Country:US
Practice Address - Phone:888-763-7272
Practice Address - Fax:877-243-2959
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-11
Last Update Date:2022-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health