Provider Demographics
NPI:1265407910
Name:CHILD AND FAMILY SUPPORT SERVICES, INC
Entity type:Organization
Organization Name:CHILD AND FAMILY SUPPORT SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:ELEFTHERIOS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:610-376-8558
Mailing Address - Street 1:4 S 4TH ST
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19602-1004
Mailing Address - Country:US
Mailing Address - Phone:610-376-8558
Mailing Address - Fax:
Practice Address - Street 1:4 S 4TH ST
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19602-1004
Practice Address - Country:US
Practice Address - Phone:610-376-8558
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA209300101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007782100006Medicaid