Organization Active NPI

Family Alternative Support Services

  • Community/Behavioral Health Agency
  • Charlotte, NC
National Provider Identifier
1649701277
Registry record updated Mar 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
FAMILY ALTERNATIVE SUPPORT SERVICES
Practice address
3205 Mallard Hill Dr
107
Charlotte, NC 28269-2023
Phone
(704) 575-2708
NPI assigned
Mar 24, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2017

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

Authorized official

Name
Kenyetta Shaw
Title
Director
Phone
(704) 575-2708

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X SC Primary

Addresses

Primary practice location

3205 Mallard Hill Dr
107
Charlotte, NC 28269-2023

Mailing address

PO Box 28
Newell, NC 28126-0028
Phone (704) 575-2708

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1490313600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490313600000",
    "number": "1649701277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 28",
            "city": "NEWELL",
            "state": "NC",
            "postal_code": "281260028",
            "telephone_number": "704-575-2708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3205 MALLARD HILL DR",
            "address_2": "107",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282692023",
            "telephone_number": "704-575-2708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY ALTERNATIVE SUPPORT SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-24",
        "last_updated": "2017-03-24",
        "status": "A",
        "authorized_official_last_name": "SHAW",
        "authorized_official_first_name": "KENYETTA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "704-575-2708"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "SC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 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.