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FAMILY INTERVENTION CENTER INC NPI 1598764474


NPI Information

NPI: 1598764474
Provider Name: FAMILY INTERVENTION CENTER, INC
Classification: Clinic/Center - 261Q00000X
Entity Type: Organization
Address:
22 CHASE RIVER RD
WATERBURY, CT
ZIP 06704
Phone: (203) 753-2153
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FAMILY INTERVENTION CENTER, INC is a clinic center in Waterbury, CT. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). FAMILY INTERVENTION CENTER, INC NPI is 1598764474. The provider is registered as an organization entity type.

The provider's business location address is:

22 CHASE RIVER RD
WATERBURY, CT
ZIP 06704-408
Phone: (203) 753-2153
Fax: (203) 756-6032

The provider's authorized official is Joseph E. Futschik .
The authorized official title is President and has the following contact phone number (203) 753-2153.

The enumeration date for this NPI number is 7/21/2005 and was last updated on 2/4/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QM0850XClinic/CenterAdult Mental Health0471CONNECTICUTNo
2101YA0400XCounselorAddiction (Substance Use Disorder)0390CONNECTICUTNo
3261Q00000XClinic/Center0390CONNECTICUTYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1004065439MEDICAIDCONNECTICUT
2=========OTHERCONNECTICUTINSURANCE
3140001006CT01OTHERCONNECTICUTANTHEM
4009022108MEDICARE ID-TYPE UNSPECIFIEDCONNECTICUTSUBMITTER NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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