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General NPI Number Information
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NPI Number | 1942552435
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Entity Type | Organization
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Legal Business Name | FAMILIES FREE INC
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Dates
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Enumeration Date | 10/08/2012
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Last Update Date | 07/24/2013
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Provider Practice Location Address
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Address Line | 2408 SUSANNAH ST
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City | JOHNSON CITY
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State | TN
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Zip | 37601-1748
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Country | US
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Telephone | 423-631-0141
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Fax | 423-631-0157
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Provider Business Mailing Address
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Address Line | PO BOX 5645
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City | JOHNSON CITY
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State | TN
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Zip | 37602-5645
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Country | US
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Telephone | 423-631-0141
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Fax | 423-631-0157
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. LISA ANN TIPTON
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Credential | BA
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Telephone | 423-773-9103
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 1000000011042
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 1000000011042
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 1000000011042
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License Number State | TN
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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 | 1000000012039
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License Number State | TN
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