Healthcare Provider Details

I. General information

NPI: 1861047706
Provider Name (Legal Business Name): FAMILIES FIRST ALWAYS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2019
Last Update Date: 08/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1717 GERVAIS ST # 104
COLUMBIA SC
29201-3415
US

IV. Provider business mailing address

873 NEAR CREEK DR
BLYTHEWOOD SC
29016-6905
US

V. Phone/Fax

Practice location:
  • Phone: 803-904-5488
  • Fax:
Mailing address:
  • Phone: 843-906-2394
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. JONIQUE MARGUERITE SMALLS COMRIE
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 803-904-5488