Provider Demographics
NPI:1407031727
Name:SUPPORT SERVICES NETWORK, INC.
Entity Type:Organization
Organization Name:SUPPORT SERVICES NETWORK, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GENARIS
Authorized Official - Middle Name:
Authorized Official - Last Name:HASTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-768-3600
Mailing Address - Street 1:PO BOX 221374
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33422-1374
Mailing Address - Country:US
Mailing Address - Phone:561-768-3600
Mailing Address - Fax:561-841-8237
Practice Address - Street 1:1213 ROSEGATE BLVD
Practice Address - Street 2:
Practice Address - City:RIVIERA BEACH
Practice Address - State:FL
Practice Address - Zip Code:33404-1821
Practice Address - Country:US
Practice Address - Phone:561-844-2799
Practice Address - Fax:561-841-8237
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-05
Last Update Date:2008-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services