Provider Demographics
NPI:1285015412
Name:FOUNDATIONAL TRUTH FAMILY SERVICES
Entity Type:Organization
Organization Name:FOUNDATIONAL TRUTH FAMILY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BRAD
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:LARNER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:989-280-3685
Mailing Address - Street 1:3144 DAVENPORT AVE
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48602-3494
Mailing Address - Country:US
Mailing Address - Phone:989-280-3685
Mailing Address - Fax:888-507-6033
Practice Address - Street 1:3144 DAVENPORT AVE
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48602-3494
Practice Address - Country:US
Practice Address - Phone:989-280-3685
Practice Address - Fax:888-507-6033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-12
Last Update Date:2015-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4101006360106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty