Healthcare Provider Details

I. General information

NPI: 1790005056
Provider Name (Legal Business Name): THE FAMILY & CHILDREN'S SOCIETY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2010
Last Update Date: 12/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

257 MAIN ST
BINGHAMTON NY
13905-2522
US

IV. Provider business mailing address

257 MAIN ST
BINGHAMTON NY
13905-2522
US

V. Phone/Fax

Practice location:
  • Phone: 607-729-6206
  • Fax: 607-729-1858
Mailing address:
  • Phone: 607-729-6206
  • Fax: 607-729-1858

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number7807003A
License Number StateNY

VIII. Authorized Official

Name: MS. LISA HOESCHELE
Title or Position: CEO
Credential:
Phone: 607-423-2764