Foundation Intervention Services LLC
Early Intervention Provider Agency in Lake Worth, FL. Organization (NPI-2).
NPI number1891237244
StatusActive
Last updated in NPPESFeb 27, 2022
Details
- NPI
- 1891237244
- Entity type
- Organization (NPI-2)
- Legal business name
- Foundation Intervention Services LLC
- Organization subpart
- No
- Enumeration date
- Nov 15, 2016
- Certification date
- Feb 8, 2022
- Last updated
- Feb 27, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 252Y00000X | Early Intervention Provider Agency | – | FL | Yes |
Practice location
4776 Via Bari Apt 6304Lake Worth, FL 33463-6793
Phone 954-326-2262
Mailing address
4776 Via Bari Apt 6304Lake Worth, FL 33463-6793
Phone 954-326-2262
Authorized official
Rushelle Campbell
Director
9543262262
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