Provider Demographics
NPI:1316537111
Name:ADVANCED FAMILY SUPPORT CORP
Entity Type:Organization
Organization Name:ADVANCED FAMILY SUPPORT CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YILENA
Authorized Official - Middle Name:
Authorized Official - Last Name:ECHERRI SIVERIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-328-8558
Mailing Address - Street 1:5561 BELROSE ST
Mailing Address - Street 2:
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33971-6446
Mailing Address - Country:US
Mailing Address - Phone:786-328-8558
Mailing Address - Fax:
Practice Address - Street 1:5561 BELROSE ST
Practice Address - Street 2:
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33971-6446
Practice Address - Country:US
Practice Address - Phone:239-201-7704
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-25
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior AnalystGroup - Single Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No251B00000XAgenciesCase ManagementGroup - Single Specialty