Healthcare Provider Details

I. General information

NPI: 1336043132
Provider Name (Legal Business Name): 28 FOUNDATIONS EMPOWERED CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3635 E 61ST ST
CLEVELAND OH
44105-1207
US

IV. Provider business mailing address

PO BOX 27437
CLEVELAND OH
44127-0437
US

V. Phone/Fax

Practice location:
  • Phone: 216-527-5765
  • Fax:
Mailing address:
  • Phone: 216-322-3818
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number StateNULL

VIII. Authorized Official

Name: JENNIFER YOUNG
Title or Position: MANAGER
Credential:
Phone: 216-322-3818