Provider Demographics
NPI:1104959717
Name:FAMILIES AND COMMUNITY TOGETHER
Entity type:Organization
Organization Name:FAMILIES AND COMMUNITY TOGETHER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FINANCE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GINA
Authorized Official - Middle Name:
Authorized Official - Last Name:WOODSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-789-8500
Mailing Address - Street 1:1170 US HIGHWAY 22
Mailing Address - Street 2:
Mailing Address - City:MOUNTAINSIDE
Mailing Address - State:NJ
Mailing Address - Zip Code:07092-2810
Mailing Address - Country:US
Mailing Address - Phone:908-789-8500
Mailing Address - Fax:908-789-8508
Practice Address - Street 1:1170 US HIGHWAY 22
Practice Address - Street 2:
Practice Address - City:MOUNTAINSIDE
Practice Address - State:NJ
Practice Address - Zip Code:07092-2810
Practice Address - Country:US
Practice Address - Phone:908-789-8500
Practice Address - Fax:908-789-8508
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8457603Medicaid