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General NPI Number Information
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NPI Number | 1922462993
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Entity Type | Organization
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Legal Business Name | FAMILY FIRST MENTOR
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Dates
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Enumeration Date | 04/06/2016
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Last Update Date | 04/06/2016
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Provider Practice Location Address
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Address Line | 2870 PELFREY RD
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City | SUMTER
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State | SC
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Zip | 29153-8031
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Country | US
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Telephone | 803-972-4516
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Fax |
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Provider Business Mailing Address
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Address Line | 2870 PELFREY RD
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City | SUMTER
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State | SC
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Zip | 29153-8031
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Country | US
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Telephone | 803-972-4516
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ROSEMARY CAPERS
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Credential |
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Telephone | 803-972-4516
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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