Provider Demographics
NPI:1487983011
Name:CATHOLIC FAMILY CENTER
Entity type:Organization
Organization Name:CATHOLIC FAMILY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TINA
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMSON
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:585-546-7220
Mailing Address - Street 1:87 N CLINTON AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14604-1455
Mailing Address - Country:US
Mailing Address - Phone:585-546-7220
Mailing Address - Fax:585-262-7036
Practice Address - Street 1:87 N CLINTON AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14604-1455
Practice Address - Country:US
Practice Address - Phone:585-546-7220
Practice Address - Fax:585-262-7036
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CATHOLIC CHARITIES OF THE DIOCESE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-12-10
Last Update Date:2009-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003812101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty