Provider Demographics
NPI:1699199745
Name:FAMILY FIRST SUPPORTIVE SERVICES INC
Entity Type:Organization
Organization Name:FAMILY FIRST SUPPORTIVE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:CASSANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITMORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-286-1872
Mailing Address - Street 1:7139 W APPLETON AVE
Mailing Address - Street 2:6
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53216-1984
Mailing Address - Country:US
Mailing Address - Phone:414-286-1872
Mailing Address - Fax:
Practice Address - Street 1:7139 W APPLETON AVE
Practice Address - Street 2:6
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53216-1984
Practice Address - Country:US
Practice Address - Phone:414-286-1872
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-10
Last Update Date:2014-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management