Provider Demographics
NPI:1700903515
Name:FAMILY CRISIS CENTER
Entity type:Organization
Organization Name:FAMILY CRISIS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MARRIAGE FAMILY THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:EEDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:FARRELL
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:818-999-5688
Mailing Address - Street 1:PO BOX 5164
Mailing Address - Street 2:
Mailing Address - City:WEST HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91308-5164
Mailing Address - Country:US
Mailing Address - Phone:818-999-5688
Mailing Address - Fax:
Practice Address - Street 1:10315 WOODLEY AVE STE 213
Practice Address - Street 2:
Practice Address - City:GRANADA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91344-6950
Practice Address - Country:US
Practice Address - Phone:818-999-5688
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36451101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA=========OtherEIN