Provider Demographics
NPI:1326405200
Name:SUSTAINABLE FAMILY SERVICES LLC
Entity Type:Organization
Organization Name:SUSTAINABLE FAMILY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:RHODES-COURTER
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:352-613-6366
Mailing Address - Street 1:8487 9TH ST N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33702-3503
Mailing Address - Country:US
Mailing Address - Phone:980-342-2090
Mailing Address - Fax:727-800-2333
Practice Address - Street 1:8487 9TH ST N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33702-3503
Practice Address - Country:US
Practice Address - Phone:727-318-3224
Practice Address - Fax:727-800-2333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-22
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL104549600Medicaid
FL108768200Medicaid