Organization
FAMILY SUPPORT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHAWN LACEY ESQ (EXECUTIVE DIRECTOR)
(610) 352-7610
Entity
Organization
Contact information
Practice address
4212 CHESTNUT ST, PHILADELPHIA, PA 19104-3015
(215) 382-3171
Mailing address
4212 CHESTNUT ST, PHILADELPHIA, PA 19104-3015
(215) 382-3171
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
03/20/2007
Last updated
03/05/2008
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