Provider Demographics
NPI:1487013413
Name:FAMILY SUPPORT SERVICES LLC
Entity Type:Organization
Organization Name:FAMILY SUPPORT SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:BRANDY
Authorized Official - Last Name:HOLMES
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:256-340-9233
Mailing Address - Street 1:1608 4TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601-4904
Mailing Address - Country:US
Mailing Address - Phone:256-340-9233
Mailing Address - Fax:256-340-9335
Practice Address - Street 1:1608 4TH AVE SE
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-4904
Practice Address - Country:US
Practice Address - Phone:256-340-9233
Practice Address - Fax:256-340-9335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-18
Last Update Date:2016-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3421101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty