Family Health Center Inc.

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

FAMILY HEALTH CENTER INC.

Practice address

3415 Hamilton St Ste 9
W Hyattsville, MD 20782-3953

Phone

(301) 779-2461

Fax

(301) 779-6095

NPI assigned

Dec 23, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Alvaro Wilfrido Jaya, CSC-ADNPI 1598228827

Title

Office Manager/Counselor

Phone

(301) 963-7222

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Alvaro W Jaya

  • Addiction (Substance Use Disorder) Counselor
  • Gaithersburg, MD
  • NPI 1598228827
  NPD (past) Authorized official
• Bruke Tadesse

  • Addiction (Substance Use Disorder) Psychologist
  • Hyattsville, MD
  • NPI 1306861752
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1608681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608681600000",
    "number": "1174110266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 MONTGOMERY VILLAGE AVE STE 400",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208793548",
            "telephone_number": "301-963-7222",
            "fax_number": "301-963-2616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3415 HAMILTON ST STE 9",
            "city": "W HYATTSVILLE",
            "state": "MD",
            "postal_code": "207823953",
            "telephone_number": "301-779-2461",
            "fax_number": "301-779-6095"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6 Montgomery Village Ave Ste 400",
            "address_purpose": "LOCATION",
            "city": "Gaithersburg",
            "state": "MD",
            "postal_code": "208793548",
            "country_code": "US",
            "telephone_number": "301-963-7222",
            "fax_number": "301-963-2616",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FAMILY HEALTH CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-23",
        "last_updated": "2020-12-23",
        "certification_date": "2020-12-18",
        "status": "A",
        "authorized_official_last_name": "JAYA",
        "authorized_official_first_name": "ALVARO",
        "authorized_official_middle_name": "WILFRIDO",
        "authorized_official_title_or_position": "OFFICE MANAGER/COUNSELOR",
        "authorized_official_telephone_number": "301-963-7222",
        "authorized_official_credential": "CSC-AD"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1316126121",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.