MEDICARE: FAMILY FOUNDATION CENTER

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1932882990
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY FOUNDATION CENTER

Provider Business Mailing Address
First Line	:	11300 NW 35TH ST
Second Line	:
City	:	SUNRISE
State	:	FL
Zip	:	33323-1418
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2230 NW 22ND ST
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33311-2913
Country	:	US
Telephone Number	:	954-716-5500
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CHRISTOPHER EWALD
Credential	:
Telephone Number	:	954-716-5500

Provider Enumeration Date	:	08/08/2023
Last Update Date	:	08/08/2023

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Directions to “FAMILY FOUNDATION CENTER ” Practice Location

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