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General NPI Number Information
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NPI Number | 1194663047
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Entity Type | Organization
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Legal Business Name | FOUNDATION YOUTH INTERVENTION
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Dates
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Enumeration Date | 03/23/2026
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Last Update Date | 03/23/2026
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Provider Practice Location Address
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Address Line | 2177 E LIVINGSTON AVE
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City | COLUMBUS
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State | OH
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Zip | 43209-2853
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Country | US
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Telephone | 614-615-0002
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Fax |
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Provider Business Mailing Address
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Address Line | 128 SHIP ML APT 204
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City | COLUMBUS
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State | OH
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Zip | 43207-3792
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Country | US
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Telephone | 614-615-0002
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. DEON PADGETT SR.
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Credential |
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Telephone | 614-615-0002
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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