Organization · NPI-2

Foundations Therapeutic Services, LLC

Social Worker, Clinical · Palmer, AK

NPI number1639733496
StatusActive
Last updated in NPPESDec 27, 2023

Details

NPI
1639733496
Entity type
Organization (NPI-2)
Legal business name
Foundations Therapeutic Services, LLC
Organization subpart
No
Enumeration date
Apr 26, 2019
Certification date
Nov 11, 2023
Last updated
Dec 27, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1041C0700X Social Worker, Clinical––Yes
261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center)––

Practice location

1901 N Hemmer Rd Ste 209
Palmer, AK 99645-9690

Phone 907-331-0123

Mailing address

Po Box 1723
Palmer, AK 99645-1723

Authorized official

Carolina Hernandez Powers
Owner
9073310123

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