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General NPI Number Information
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NPI Number | 1710405121
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Entity Type | Organization
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Legal Business Name | FAMILY ENGAGEMENT & SUPPORT SERVICES
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Dates
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Enumeration Date | 09/06/2017
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Last Update Date | 09/06/2017
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Provider Practice Location Address
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Address Line | 1043 COBBLESTONE BLVD
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City | SUMMERVILLE
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State | SC
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Zip | 29486-2083
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Country | US
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Telephone | 843-781-3468
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Fax | 843-781-3468
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Provider Business Mailing Address
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Address Line | 1317M N MAIN ST STE 318
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City | SUMMERVILLE
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State | SC
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Zip | 29483-7307
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Country | US
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Telephone | 843-620-1570
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MS. ALISHA SIMMONS
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Credential |
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Telephone | 843-781-3468
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management 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 | 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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