Provider Demographics
NPI:1740997923
Name:FAMILIA SUPPORTING HAND, LLC
Entity type:Organization
Organization Name:FAMILIA SUPPORTING HAND, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAVIER
Authorized Official - Middle Name:
Authorized Official - Last Name:SANES-SANTIAGO
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:904-329-0267
Mailing Address - Street 1:6015 CHESTER CIR STE 113
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32217-2270
Mailing Address - Country:US
Mailing Address - Phone:904-853-0739
Mailing Address - Fax:
Practice Address - Street 1:6015 CHESTER CIR STE 113
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32217-2270
Practice Address - Country:US
Practice Address - Phone:904-853-0739
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-28
Last Update Date:2023-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty