Provider Demographics
NPI:1548611239
Name:FAMILY FIRST DEVELOPMENTAL SERVICES
Entity type:Organization
Organization Name:FAMILY FIRST DEVELOPMENTAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEVELOPMENTAL THERAPY
Authorized Official - Prefix:MS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:DIANNE
Authorized Official - Last Name:PIERCE
Authorized Official - Suffix:
Authorized Official - Credentials:DI
Authorized Official - Phone:270-287-8601
Mailing Address - Street 1:543 SAINT CLOUD WAY
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42101-5502
Mailing Address - Country:US
Mailing Address - Phone:270-287-8601
Mailing Address - Fax:270-971-1464
Practice Address - Street 1:543 SAINT CLOUD WAY
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42101-5502
Practice Address - Country:US
Practice Address - Phone:270-287-8601
Practice Address - Fax:270-971-1464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-24
Last Update Date:2020-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency