Provider Demographics
NPI:1811177116
Name:FAMILY FOCUSED COMMUNITY SUPPORT SERVICES INC.
Entity type:Organization
Organization Name:FAMILY FOCUSED COMMUNITY SUPPORT SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:VIVIAN
Authorized Official - Middle Name:MAE
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:BA,AA,QP
Authorized Official - Phone:910-670-0308
Mailing Address - Street 1:1379 WORSTEAD DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28314-5452
Mailing Address - Country:US
Mailing Address - Phone:910-229-5002
Mailing Address - Fax:
Practice Address - Street 1:1379 WORSTEAD DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28314-5452
Practice Address - Country:US
Practice Address - Phone:910-670-0308
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-05
Last Update Date:2013-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health