Provider Demographics
NPI:1215403456
Name:SENIOR CHARITY CARE FOUNDATION
Entity Type:Organization
Organization Name:SENIOR CHARITY CARE FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:FOUST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-718-2563
Mailing Address - Street 1:721 N MAIN ST # 106
Mailing Address - Street 2:
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84041-2231
Mailing Address - Country:US
Mailing Address - Phone:801-515-0480
Mailing Address - Fax:
Practice Address - Street 1:1555 S 2200 W
Practice Address - Street 2:STE B
Practice Address - City:WEST VALLEY CITY
Practice Address - State:UT
Practice Address - Zip Code:84119-8411
Practice Address - Country:US
Practice Address - Phone:801-515-0480
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-15
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223D0001XDental ProvidersDentistDental Public HealthGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No251V00000XAgenciesVoluntary or CharitableGroup - Multi-Specialty