MEDICARE: FAMILY SERVICES UNLIMITED, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251B00000X	Case Management Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124185954
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY SERVICES UNLIMITED, INC

Provider Business Mailing Address
First Line	:	8075 MALL PKWY
Second Line	:	SUITE 101-334
City	:	LITHONIA
State	:	GA
Zip	:	30038-6993
Country	:	US
Telephone Number	:	404-944-6166
Fax Number	:	770-322-0487

Provider Business Practice Location Address
First Line	:	8075 MALL PKWY
Second Line	:	SUITE 101-334
City	:	LITHONIA
State	:	GA
Zip	:	30038-6993
Country	:	US
Telephone Number	:	404-944-6166
Fax Number	:	770-322-0487

Authorized Official
Title or Position	:	CASE MANAGER
Name	:	MS. KEISHA MILLER
Credential	:	MA
Telephone Number	:	404-944-6166

Provider Enumeration Date	:	01/02/2007
Last Update Date	:	01/09/2009

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