Basic Information
| Provider Information | |||||||||
| NPI: | 1437763760 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | FAMILY FOCUS, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 660 MORTHLAND DR STE A | ||||||||
| Address2: | |||||||||
| City: | VALPARAISO | ||||||||
| State: | IN | ||||||||
| PostalCode: | 463854638 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2194629200 | ||||||||
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| Practice Location | |||||||||
| Address1: | 660 MORTHLAND DR STE A | ||||||||
| Address2: | |||||||||
| City: | VALPARAISO | ||||||||
| State: | IN | ||||||||
| PostalCode: | 463854638 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2194629200 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/03/2020 | ||||||||
| LastUpdateDate: | 09/03/2020 | ||||||||
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| AuthorizedOfficialLastName: | RAFALSKI | ||||||||
| AuthorizedOfficialFirstName: | MARK | ||||||||
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| AuthorizedOfficialTitleorPosition: | CHIEF OPERATING OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 2194629200 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | FAMILY FOCUS, INC | ||||||||
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| AuthorizedOfficialCredential: | MBA | ||||||||
| NPICertificationDate: | 09/03/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QM0850X | Y | Ambulatory Health Care Facilities | Clinic/Center | Adult Mental Health |
No ID Information.