Organization
FAMILY SUPPORT CIRCLE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELNA JEANTINE ED.D. (PRESIDENT/FOUNDER)
(770) 378-4070
Entity
Organization
Contact information
Practice address
1479 TETHER LN, MCDONOUGH, GA 30253-9209
(770) 378-4070
Mailing address
1479 TETHER LN, P.O.BOX 2439, MCDONOUGH, GA 30253-9209
(770) 378-4070
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
GA
103TB0200X
Cognitive & Behavioral Psychologist
—
GA
251V00000X
Voluntary or Charitable Agency
Primary
—
—
3245S0500X
Children's Substance Abuse Rehabilitation Facility
—
GA
385HR2055X
Child Mental Illness Respite Care
—
GA
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
GA
Other
Enumeration date
09/30/2010
Last updated
09/30/2010
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