Provider Demographics
NPI:1144816448
Name:FAMILY SUPPORT CIRCLE, INC
Entity type:Organization
Organization Name:FAMILY SUPPORT CIRCLE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ELNA
Authorized Official - Middle Name:
Authorized Official - Last Name:POULARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-917-9765
Mailing Address - Street 1:14750 S SPUR DR
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33161-2109
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14750 S SPUR DR
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33161-2109
Practice Address - Country:US
Practice Address - Phone:404-917-9765
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-21
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251S00000XAgenciesCommunity/Behavioral Health
No253Z00000XAgenciesIn Home Supportive Care