Organization
FAMILY SUPPORT CIRCLE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELNA POULARD PHD (PRESIDENT)
(404) 917-9765
Entity
Organization
Contact information
Practice address
2059 E CHELTEN AVE, PHILADELPHIA, PA 19138-3043
(267) 335-5857
(267) 385-6119
Mailing address
2059 E CHELTEN AVE, PHILADELPHIA, PA 19138-3043
(267) 335-5857
(267) 385-6119
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
22343601
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000006490002
—
PA
01
—
22343601
HOME CARE LICENSE NUMBER
PA
Enumeration date
09/01/2015
Last updated
09/01/2015
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