Healthcare Provider Details
I. General information
NPI: 1144341421
Provider Name (Legal Business Name): FAMILY & CHILDREN'S AGENCY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/03/2007
Last Update Date: 06/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9 MOTT AVE
NORWALK CT
06850-3330
US
IV. Provider business mailing address
9 MOTT AVE 4TH FLOOR
NORWALK CT
06850-3330
US
V. Phone/Fax
- Phone: 203-855-8765
- Fax: 203-838-3325
- Phone: 203-855-8765
- Fax: 203-838-3325
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0850X |
| Taxonomy | Adult Mental Health Clinic/Center |
| License Number | 0322 |
| License Number State | CT |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QR0405X |
| Taxonomy | Substance Use Disorder Rehabilitation Clinic/Center |
| License Number | SA-0137 |
| License Number State | CT |
VIII. Authorized Official
Name:
ROBERT
F
CASHEL
Title or Position: PRESIDENT & CEO
Credential: LCSW
Phone: 203-855-8765