Provider Demographics
NPI:1114340429
Name:INSTITUTE FOR FAMILY CENTERED SERVICES INC.
Entity type:Organization
Organization Name:INSTITUTE FOR FAMILY CENTERED SERVICES INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP & SR ASST GENERAL COUNSEL
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:PATRICIA
Authorized Official - Last Name:RODENBERG-ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-836-2234
Mailing Address - Street 1:9166 ANAHEIM PL
Mailing Address - Street 2:SUITE 200
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-8547
Mailing Address - Country:US
Mailing Address - Phone:909-483-2505
Mailing Address - Fax:909-483-2119
Practice Address - Street 1:1000 S FREMONT AVE BLDG A-10
Practice Address - Street 2:SUITE 10350, UNIT 98
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91803-8857
Practice Address - Country:US
Practice Address - Phone:626-607-0202
Practice Address - Fax:626-607-0203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-23
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health