Organization
SUPPORTIVE FAMILY SERVICES
Active
Other names
Supportive Family Services
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PAMBLET SMITH JOHNSON (OWNER)
(804) 955-5853
Entity
Organization
Contact information
Practice address
2189 K V RD, VICTORIA, VA 23974-2538
(804) 885-0773
Mailing address
3013 CRESSWELL RD, NORTH CHESTERFIELD, VA 23237-3459
(804) 218-5649
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
310400000X
Assisted Living Facility
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Enumeration date
03/25/2019
Last updated
08/02/2023
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