Provider Demographics
NPI:1073715082
Name:FAMILY SUPPORT SERVICES
Entity Type:Organization
Organization Name:FAMILY SUPPORT SERVICES
Other - Org Name:GROWING UP STRONG
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:ADEYI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-834-2443
Mailing Address - Street 1:303 HEGENBERGER RD STE 400
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94621-1419
Mailing Address - Country:US
Mailing Address - Phone:510-834-2443
Mailing Address - Fax:510-834-1548
Practice Address - Street 1:303 HEGENBERGER RD STE 400
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94621-1419
Practice Address - Country:US
Practice Address - Phone:510-834-2443
Practice Address - Fax:510-834-1548
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-01
Last Update Date:2018-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA01CXMedicaid