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General NPI Number Information
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NPI Number | 1245093095
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Entity Type | Organization
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Legal Business Name | THREE FAMILY SUPPORT, LLC
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Dates
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Enumeration Date | 02/05/2024
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Last Update Date | 02/05/2024
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Provider Practice Location Address
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Address Line | 1026 STONECLIFFE DR
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City | MONROEVILLE
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State | PA
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Zip | 15146-3203
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Country | US
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Telephone | 412-579-2094
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Fax |
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Provider Business Mailing Address
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Address Line | 102 SPRING GROVE RD
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City | PITTSBURGH
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State | PA
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Zip | 15235-1804
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Country | US
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Telephone | 412-579-2094
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. THERONE WADE-WHITE SR.
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Credential | PHD
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Telephone | 412-579-2094
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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