Familyties Support Services, LLC

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

License

015600300 Issued in FL

Legal business name

FAMILYTIES SUPPORT SERVICES, LLC

Practice address

1120 Silas Dr SW Apt 1406
Live Oak, FL 32064-2969

Phone

(813) 482-7962

Fax

(813) 415-2266

NPI assigned

Jan 10, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Loris Tucker

Title

Partner/Director

Phone

(813) 482-7962

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1484006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484006400000",
    "number": "1003352352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 SILAS DR SW APT 1406",
            "city": "LIVE OAK",
            "state": "FL",
            "postal_code": "320642969",
            "telephone_number": "813-482-7962",
            "fax_number": "813-415-2266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 SILAS DR SW APT 1406",
            "city": "LIVE OAK",
            "state": "FL",
            "postal_code": "320642969",
            "telephone_number": "813-482-7962",
            "fax_number": "813-415-2266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILYTIES SUPPORT SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-10",
        "last_updated": "2017-01-10",
        "status": "A",
        "authorized_official_last_name": "TUCKER",
        "authorized_official_first_name": "LORIS",
        "authorized_official_title_or_position": "PARTNER/DIRECTOR",
        "authorized_official_telephone_number": "813-482-7962",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "FL",
            "license": "015600300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "015717400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Developmentally Disabled Services Day Training Agency in Live Oak, FL
• Providers in Live Oak, FL by specialty
• Developmentally Disabled Services Day Training Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.