Provider Demographics
NPI:1366998908
Name:FAMILY PEER SUPPORT SERVICES OF CHAUTAUQUA COUNTY, INC.
Entity type:Organization
Organization Name:FAMILY PEER SUPPORT SERVICES OF CHAUTAUQUA COUNTY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELODY
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-753-4157
Mailing Address - Street 1:2 ACADEMY STREET, SUITE 202
Mailing Address - Street 2:
Mailing Address - City:MAYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14757
Mailing Address - Country:US
Mailing Address - Phone:716-753-4157
Mailing Address - Fax:716-753-9768
Practice Address - Street 1:2 ACADEMY ST RM 202
Practice Address - Street 2:
Practice Address - City:MAYVILLE
Practice Address - State:NY
Practice Address - Zip Code:14757-1050
Practice Address - Country:US
Practice Address - Phone:716-753-4157
Practice Address - Fax:716-753-9768
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable