Provider Demographics
NPI:1760655831
Name:FAMILY SUPPORT SYSTEMS UNLIMITED, INC.
Entity Type:Organization
Organization Name:FAMILY SUPPORT SYSTEMS UNLIMITED, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:J
Authorized Official - Last Name:HART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-220-5400
Mailing Address - Street 1:2530 GRAND CONCOURSE
Mailing Address - Street 2:9TH FLOOR
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10458-4904
Mailing Address - Country:US
Mailing Address - Phone:718-220-5400
Mailing Address - Fax:718-220-3152
Practice Address - Street 1:2530 GRAND CONCOURSE
Practice Address - Street 2:9TH FLOOR
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10458-4904
Practice Address - Country:US
Practice Address - Phone:718-220-5400
Practice Address - Fax:718-220-3152
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-09
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY01200935253J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01200935Medicaid