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General NPI Number Information
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NPI Number | 1942536941
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Entity Type | Organization
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Legal Business Name | THERAPEUTIC FOUNDATIONS
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Dates
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Enumeration Date | 10/26/2009
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Last Update Date | 10/26/2009
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Provider Practice Location Address
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Address Line | 1181 DAL MASO DR
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City | DAYTONA BEACH
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State | FL
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Zip | 32117-4109
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Country | US
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Telephone | 386-846-3351
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Fax | 386-226-2076
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Provider Business Mailing Address
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Address Line | 1181 DAL MASO DR
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City | DAYTONA BEACH
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State | FL
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Zip | 32117-4109
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Country | US
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Telephone | 386-846-3351
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Fax | 386-226-2076
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Authorized Official
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Title or Position | CEO
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Name | MS. DAWN LOUISE NAIMOLI
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Credential | MA, BCBA
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Telephone | 386-846-3351
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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 | 686174196
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number | 686174196
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License Number State | FL
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