NPIMap

Organization Active NPI

Family Support Circle, Inc.

  • Voluntary or Charitable Agency
  • McDonough, GA
National Provider Identifier
1336458991
Registry record updated Sep 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Voluntary or Charitable AgencyTaxonomy code 251V00000X
Legal business name
FAMILY SUPPORT CIRCLE, INC.
Practice address
1479 Tether LN
McDonough, GA 30253-9209
Phone
(770) 378-4070
NPI assigned
Sep 30, 2010
Last updated
Sep 30, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2010

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

Authorized official

Name
Dr. Elna Jeantine, ED.D.
Title
President/Founder
Phone
(770) 378-4070

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Voluntary or Charitable Agency 251V00000X Primary
Children's Substance Abuse Rehabilitation Facility 3245S0500X GA
Professional Counselor 101YP2500X GA
Cognitive & Behavioral Psychologist 103TB0200X GA
Child Mental Illness Respite Care 385HR2055X GA
Child Intellectual and/or Developmental Disabilities Respite Care 385HR2060X GA

Addresses

Primary practice location

1479 Tether LN
McDonough, GA 30253-9209

Mailing address

1479 Tether LN
P.O.Box 2439
McDonough, GA 30253-9209
Phone (770) 378-4070

National Provider Directory

National Provider Directory
Tax ID family
Family Support Circle Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1285804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285804800000",
    "number": "1336458991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1479 TETHER LN",
            "address_2": "P.O.BOX 2439",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302539209",
            "telephone_number": "770-378-4070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1479 TETHER LN",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302539209",
            "telephone_number": "770-378-4070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY SUPPORT CIRCLE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-30",
        "last_updated": "2010-09-30",
        "status": "A",
        "authorized_official_last_name": "JEANTINE",
        "authorized_official_first_name": "ELNA",
        "authorized_official_title_or_position": "PRESIDENT/FOUNDER",
        "authorized_official_telephone_number": "770-378-4070",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "ED.D."
    },
    "taxonomies": [
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3245S0500X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
            "state": "GA",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": null,
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "GA",
            "license": null,
            "primary": false
        },
        {
            "code": "385HR2055X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Mental Illness, Child",
            "state": "GA",
            "license": null,
            "primary": false
        },
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": "GA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McDonough, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2010; 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.