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General NPI Number Information
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NPI Number | 1205169018
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Entity Type | Organization
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Legal Business Name | FAMILIES FIRST SUPPORT SERVICES, LLC
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Dates
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Enumeration Date | 09/10/2009
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Last Update Date | 02/22/2018
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Provider Practice Location Address
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Address Line | 132 ELIZABETH AVE SUITE A
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City | SHELBY
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State | NC
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Zip | 28150-4991
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Country | US
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Telephone | 704-406-9770
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Fax | 704-406-9771
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Provider Business Mailing Address
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Address Line | 1427 E MARION ST STE C
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City | SHELBY
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State | NC
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Zip | 28150-4980
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Country | US
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Telephone | 704-406-9770
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Fax | 704-406-9771
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Authorized Official
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Title or Position | PRINCIPAL/FINANCE OFFICER
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Name | DOUGLAS HERSHEY
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Credential |
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Telephone | 704-572-9038
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | DSS5416A
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License Number State | NC
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