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General NPI Number Information
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NPI Number | 1386837490
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Entity Type | Organization
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Legal Business Name | CENTRO MULTICULTURAL LA FAMILIA, INC
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Dates
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Enumeration Date | 08/22/2007
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Last Update Date | 02/07/2008
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Provider Practice Location Address
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Address Line | 35 W HURON ST SUITE 500
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City | PONTIAC
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State | MI
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Zip | 48342-2120
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Country | US
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Telephone | 248-858-7800
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Fax | 248-874-4830
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Provider Business Mailing Address
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Address Line | 35 W HURON ST SUITE 500
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City | PONTIAC
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State | MI
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Zip | 48342-2120
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Country | US
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Telephone | 248-858-7800
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Fax | 248-874-4830
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | DR. SONIA ACOSTA
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Credential | PHD
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Telephone | 248-858-7800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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