Provider Demographics
NPI:1245307628
Name:FAMILY AND CHILDREN'S SERVICE
Entity type:Organization
Organization Name:FAMILY AND CHILDREN'S SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:MCSURDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-320-0591
Mailing Address - Street 1:201 23RD AVE NORTH
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203
Mailing Address - Country:US
Mailing Address - Phone:615-320-0591
Mailing Address - Fax:615-321-3906
Practice Address - Street 1:201 23RD AVE NORTH
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203
Practice Address - Country:US
Practice Address - Phone:615-320-0591
Practice Address - Fax:615-321-3906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2011-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN369917Medicaid
TN3923810Medicaid
TN369917Medicaid