Provider Demographics
NPI:1437453453
Name:FAMILY FIRST SUPPORT CENTER INC
Entity type:Organization
Organization Name:FAMILY FIRST SUPPORT CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:CALHOUN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, LPCS, LCAS, CCS
Authorized Official - Phone:919-271-2668
Mailing Address - Street 1:770 VAIL RD
Mailing Address - Street 2:
Mailing Address - City:PIKEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27863-9446
Mailing Address - Country:US
Mailing Address - Phone:919-271-2668
Mailing Address - Fax:919-635-3388
Practice Address - Street 1:110 SW CENTER ST
Practice Address - Street 2:
Practice Address - City:MOUNT OLIVE
Practice Address - State:NC
Practice Address - Zip Code:28365
Practice Address - Country:US
Practice Address - Phone:919-635-3344
Practice Address - Fax:919-635-3388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-05
Last Update Date:2018-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8303461Medicaid