Provider Demographics
NPI:1215182712
Name:FOUNDCARE, INC.
Entity Type:Organization
Organization Name:FOUNDCARE, INC.
Other - Org Name:FOUNDCARE HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:YOLETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:BONNET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-472-9160
Mailing Address - Street 1:2330 S CONGRESS AVE FL 1
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33406-7608
Mailing Address - Country:US
Mailing Address - Phone:561-432-5849
Mailing Address - Fax:561-432-9732
Practice Address - Street 1:2330 S CONGRESS AVE
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33406-7608
Practice Address - Country:US
Practice Address - Phone:561-472-9160
Practice Address - Fax:561-868-5652
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-25
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC7953261QF0400X
261QR0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No261QR0206XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mammography
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001182601Medicaid