Basic Information
| Provider Information | |||||||||
| NPI: | 1851507990 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | FAMILY EMPOWERMENT COUNCIL, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 225 DOLSON AVE | ||||||||
| Address2: | SUITE 403 | ||||||||
| City: | MIDDLETOWN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 109406569 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8453438100 | ||||||||
| FaxNumber: | 8453434477 | ||||||||
| Practice Location | |||||||||
| Address1: | 225 DOLSON AVE | ||||||||
| Address2: | SUITE 403 | ||||||||
| City: | MIDDLETOWN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 109406569 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8453438100 | ||||||||
| FaxNumber: | 8453434477 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/15/2007 | ||||||||
| LastUpdateDate: | 01/30/2015 | ||||||||
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| AuthorizedOfficialLastName: | ANDERSON-WINCHELL | ||||||||
| AuthorizedOfficialFirstName: | AMY | ||||||||
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| AuthorizedOfficialTitleorPosition: | CHIEF EXECUTIVE OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 8456924454 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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| AuthorizedOfficialCredential: | LCSW | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 253Z00000X | N | Agencies | In Home Supportive Care | 251B00000X | Y | Agencies | Case Management |
ID Information
| ID | Type | State | Issuer | Description | 02275643 | 05 | NY | MEDICAID | 01604448 | 05 | NY | MEDICAID | 01738485 | 05 | NY | MEDICAID |