Healthcare Provider Details

I. General information

NPI: 1396809778
Provider Name (Legal Business Name): CHILD AND FAMILY FOCUS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2006
Last Update Date: 10/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 MADISON AVE
AUDUBON PA
19403-2307
US

IV. Provider business mailing address

920 MADISON AVE
AUDUBON PA
19403-2307
US

V. Phone/Fax

Practice location:
  • Phone: 610-650-7759
  • Fax: 610-650-7759
Mailing address:
  • Phone: 610-650-7759
  • Fax: 610-650-7759

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number120350
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number120340
License Number StatePA

VIII. Authorized Official

Name: MR. MEL BWINT
Title or Position: CEO
Credential: MSW
Phone: 610-650-7750