Healthcare Provider Details

I. General information

NPI: 1952674012
Provider Name (Legal Business Name): CATHOLIC FAMILY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2012
Last Update Date: 02/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

87 N CLINTON AVE
ROCHESTER NY
14604-1455
US

IV. Provider business mailing address

118 COLLENTON DR
ROCHESTER NY
14626-4468
US

V. Phone/Fax

Practice location:
  • Phone: 585-546-7220
  • Fax: 585-770-1116
Mailing address:
  • Phone: 585-944-3974
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License NumberF401456-1
License Number StateNY

VIII. Authorized Official

Name: MISS DEBORAH L. SPENCER
Title or Position: PSYCHIATRIC NURSE PRACTITIONER
Credential: NPP
Phone: 585-546-7220