Healthcare Provider Details

I. General information

NPI: 1356274377
Provider Name (Legal Business Name): NUFOUNDATION YOUTH SERVICES LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12740 W INDIAN SCHOOL RD
LITCHFIELD PARK AZ
85340-6528
US

IV. Provider business mailing address

12740 W INDIAN SCHOOL RD
LITCHFIELD PARK AZ
85340-6528
US

V. Phone/Fax

Practice location:
  • Phone: 951-447-3744
  • Fax:
Mailing address:
  • Phone: 951-447-3744
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name: MR. KELVIN DONYELL FLEMING SR.
Title or Position: CEO/FOUNDER
Credential:
Phone: 951-447-3744