Provider Demographics
NPI:1982963260
Name:FAMILY GUIDANCE CENTER CORPORATION
Entity Type:Organization
Organization Name:FAMILY GUIDANCE CENTER CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:LAMAR
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:609-586-0668
Mailing Address - Street 1:1931 NOTTINGHAM WAY
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-3554
Mailing Address - Country:US
Mailing Address - Phone:609-586-0668
Mailing Address - Fax:
Practice Address - Street 1:946 EDGEWOOD AVE
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08618-5304
Practice Address - Country:US
Practice Address - Phone:609-587-6641
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-08
Last Update Date:2012-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ2000206101YA0400X
251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty