=====================================================
General NPI Number Information
=====================================================
NPI Number | 1154537306
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | THE FAMILY ENRICHMENT CENTER, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/15/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1002 E DR MARTIN LUTHER KING JR BLVD
-----------------------------------------------------
City | TAMPA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33603-4312
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 813-237-2530
-----------------------------------------------------
Fax | 813-231-7196
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1002 E DR MARTIN LUTHER KING JR BLVD
-----------------------------------------------------
City | TAMPA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33603-4312
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 813-237-2530
-----------------------------------------------------
Fax | 813-231-7196
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EXECUTIVE DIRECTOR
-----------------------------------------------------
Name | MS. OLGA S WILLIAMS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 813-237-2530
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251B00000X
-----------------------------------------------------
Taxonomy Name | Case Management Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------