Provider Demographics
NPI:1952083750
Name:FAMILY GUIDANCE CENTERS, INC.
Entity Type:Organization
Organization Name:FAMILY GUIDANCE CENTERS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:NOTTAGE
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:312-943-6545
Mailing Address - Street 1:333 W EVERGREEN ST
Mailing Address - Street 2:
Mailing Address - City:MANTENO
Mailing Address - State:IL
Mailing Address - Zip Code:60950-9329
Mailing Address - Country:US
Mailing Address - Phone:815-468-6556
Mailing Address - Fax:
Practice Address - Street 1:333 W EVERGREEN ST
Practice Address - Street 2:
Practice Address - City:MANTENO
Practice Address - State:IL
Practice Address - Zip Code:60950-9329
Practice Address - Country:US
Practice Address - Phone:815-468-6556
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-02
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)