Provider Demographics
NPI:1356716328
Name:FAMILY AND CHILDREN SUPPORT, INC
Entity type:Organization
Organization Name:FAMILY AND CHILDREN SUPPORT, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNEITH
Authorized Official - Middle Name:
Authorized Official - Last Name:DURDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-455-2092
Mailing Address - Street 1:1639 BRADLEY PARK DR
Mailing Address - Street 2:500
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31904-3620
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5910 GA HIGHWAY 21 S
Practice Address - Street 2:UNIT 6
Practice Address - City:RINCON
Practice Address - State:GA
Practice Address - Zip Code:31326-5505
Practice Address - Country:US
Practice Address - Phone:912-988-3649
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-02
Last Update Date:2015-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty