Provider Demographics
NPI:1023677689
Name:FAMILY SUPPORT CENTER OF SOUTH SOUND
Entity type:Organization
Organization Name:FAMILY SUPPORT CENTER OF SOUTH SOUND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TRISH
Authorized Official - Middle Name:
Authorized Official - Last Name:GREGORY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-754-9297
Mailing Address - Street 1:3545 7TH AVE SW STE 200
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98502-5010
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:360-943-1139
Practice Address - Street 1:3545 7TH AVE SW STE 200
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502-5010
Practice Address - Country:US
Practice Address - Phone:360-754-9297
Practice Address - Fax:360-943-1139
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-07
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management