Provider Demographics
NPI:1437582574
Name:FILMORE FOUNDATION LLC
Entity Type:Organization
Organization Name:FILMORE FOUNDATION LLC
Other - Org Name:THE KAIROS COUNSELING CENTRE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:MARC
Authorized Official - Last Name:FILMORE
Authorized Official - Suffix:
Authorized Official - Credentials:LPCMH
Authorized Official - Phone:605-229-9041
Mailing Address - Street 1:415 S MAIN ST
Mailing Address - Street 2:SUITE 305
Mailing Address - City:ABERDEEN
Mailing Address - State:SD
Mailing Address - Zip Code:57401-4364
Mailing Address - Country:US
Mailing Address - Phone:605-229-9041
Mailing Address - Fax:
Practice Address - Street 1:415 S MAIN ST
Practice Address - Street 2:SUITE 305
Practice Address - City:ABERDEEN
Practice Address - State:SD
Practice Address - Zip Code:57401-4364
Practice Address - Country:US
Practice Address - Phone:605-229-9041
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-13
Last Update Date:2013-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180008697251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health