Provider Demographics
NPI:1710405121
Name:FAMILY ENGAGEMENT & SUPPORT SERVICES
Entity Type:Organization
Organization Name:FAMILY ENGAGEMENT & SUPPORT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:ALISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-781-3468
Mailing Address - Street 1:1317M N MAIN ST STE 318
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29483-7307
Mailing Address - Country:US
Mailing Address - Phone:843-620-1570
Mailing Address - Fax:
Practice Address - Street 1:1043 COBBLESTONE BLVD
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29486-2083
Practice Address - Country:US
Practice Address - Phone:843-781-3468
Practice Address - Fax:843-781-3468
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-06
Last Update Date:2017-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management