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General NPI Number Information
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NPI Number | 1881760098
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Entity Type | Organization
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Legal Business Name | FAMILY NETWORK SERVICES, INC.
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Dates
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Enumeration Date | 11/28/2006
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Last Update Date | 01/04/2008
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Provider Practice Location Address
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Address Line | 3219 LANDMARK ST STE 3A
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City | GREENVILLE
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State | NC
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Zip | 27834-7688
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Country | US
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Telephone | 252-551-2273
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Fax | 252-355-5554
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Provider Business Mailing Address
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Address Line | 2078 MERCURY DR
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City | GREENVILLE
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State | NC
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Zip | 27858-7115
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Country | US
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Telephone | 252-531-2172
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. RONALD J. BLAKE
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Credential |
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Telephone | 252-531-2172
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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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 | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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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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