Healthcare Provider Details

I. General information

NPI: 1639219389
Provider Name (Legal Business Name): FOUNDATIONS THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2007
Last Update Date: 06/14/2023
Certification Date: 06/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8130 ROYAL PALM BLVD STE 105
CORAL SPRINGS FL
33065-5703
US

IV. Provider business mailing address

8130 ROYAL PALM BLVD STE 105
CORAL SPRINGS FL
33065-5703
US

V. Phone/Fax

Practice location:
  • Phone: 954-344-6550
  • Fax: 954-344-8634
Mailing address:
  • Phone: 954-344-6550
  • Fax: 954-344-8634

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: IVY KAPLAN
Title or Position: B.C.B.A.
Credential:
Phone: 954-344-6550