MEDICARE: FOUNDATIONS TOTAL CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	3140N1450X	Pediatric Skilled Nursing Facility
2	385HR2065X	Child Physical Disabilities Respite Care
3	251C00000X	Developmentally Disabled Services Day Training Agency
4	251J00000X	Nursing Care Agency
5	253Z00000X	In Home Supportive Care Agency
6	385H00000X	Respite Care
7	314000000X	Skilled Nursing Facility
8	385HR2060X	Child Intellectual and/or Developmental Disabilities Respite Care
9	252Y00000X	Early Intervention Provider Agency
10	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1497575435
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FOUNDATIONS TOTAL CARE LLC

Provider Business Mailing Address
First Line	:	12 W WENGER RD STE S
Second Line	:
City	:	ENGLEWOOD
State	:	OH
Zip	:	45322-2755
Country	:	US
Telephone Number	:	937-540-0202
Fax Number	:	937-998-1036

Provider Business Practice Location Address
First Line	:	12 W WENGER RD STE S
Second Line	:
City	:	ENGLEWOOD
State	:	OH
Zip	:	45322-2755
Country	:	US
Telephone Number	:	937-540-0202
Fax Number	:	937-998-1036

Authorized Official
Title or Position	:	DIRECTOR OF OPERATIONS/ OWNER
Name	:	TEAIRA N MALLORY
Credential	:
Telephone Number	:	937-422-7330

Provider Enumeration Date	:	10/15/2024
Last Update Date	:	12/12/2025

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