Provider Demographics
NPI:1649547191
Name:FAMILY SUPPORT CIRCLE, INC.
Entity type:Organization
Organization Name:FAMILY SUPPORT CIRCLE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/FOUNDER
Authorized Official - Prefix:MS
Authorized Official - First Name:ELNA
Authorized Official - Middle Name:
Authorized Official - Last Name:POULARD
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:404-917-9765
Mailing Address - Street 1:6600 N 12TH ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19126-3201
Mailing Address - Country:US
Mailing Address - Phone:267-329-9046
Mailing Address - Fax:
Practice Address - Street 1:2059 E CHELTEN AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19138-3043
Practice Address - Country:US
Practice Address - Phone:267-335-5857
Practice Address - Fax:267-385-6119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-29
Last Update Date:2018-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care
No347C00000XTransportation ServicesPrivate Vehicle
No385HR2055XRespite Care FacilityRespite CareRespite Care, Mental Illness, Child
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child