Healthcare Provider Details
I. General information
NPI: 1124751003
Provider Name (Legal Business Name): FOUNDCARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/07/2022
Last Update Date: 12/17/2024
Certification Date: 12/17/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1901 S CONGRESS AVE STE 100
BOYNTON BEACH FL
33426-6556
US
IV. Provider business mailing address
2330 S CONGRESS AVE
WEST PALM BEACH FL
33406-7608
US
V. Phone/Fax
- Phone: 561-274-6400
- Fax: 561-274-3912
- Phone: 561-432-5849
- Fax: 561-432-9732
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QF0400X |
| Taxonomy | Federally Qualified Health Center (FQHC) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CHRISTOPHER
FRANCIS
IRIZARRY
Title or Position: CEO
Credential:
Phone: 561-432-7901