Provider Demographics
NPI:1336439421
Name:CHILDRENS FRIEND AND FAMILIES
Entity type:Organization
Organization Name:CHILDRENS FRIEND AND FAMILIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY PARTNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ROSE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:GUTIERREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-644-2639
Mailing Address - Street 1:112 MARKET ST FL 2
Mailing Address - Street 2:
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01901-1125
Mailing Address - Country:US
Mailing Address - Phone:781-593-7676
Mailing Address - Fax:781-595-1081
Practice Address - Street 1:112 MARKET ST FL 2
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01901-1125
Practice Address - Country:US
Practice Address - Phone:781-593-7676
Practice Address - Fax:781-595-1081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-11
Last Update Date:2011-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA101Y00000X251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health