Healthcare Provider Details

I. General information

NPI: 1831237262
Provider Name (Legal Business Name): FAMILY FIRST SUPPORT CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2007
Last Update Date: 07/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 SW CENTER ST
MOUNT OLIVE NC
28365
US

IV. Provider business mailing address

770 VAIL RD
PIKEVILLE NC
27863-9446
US

V. Phone/Fax

Practice location:
  • Phone: 919-635-3344
  • Fax: 919-635-3388
Mailing address:
  • Phone: 919-635-3344
  • Fax: 919-635-3388

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MR. HOWARD CALHOUN
Title or Position: CEO/PRESIDENT
Credential: LPC, LCAS, CCS
Phone: 919-635-3344