Provider Demographics
NPI:1477214591
Name:FOUNDATION THERAPIES, INC.
Entity Type:Organization
Organization Name:FOUNDATION THERAPIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BETH
Authorized Official - Middle Name:
Authorized Official - Last Name:RYLAND
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMFT
Authorized Official - Phone:651-472-6535
Mailing Address - Street 1:106 CHESTNUT ST E # 308
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:MN
Mailing Address - Zip Code:55082-5116
Mailing Address - Country:US
Mailing Address - Phone:651-472-6535
Mailing Address - Fax:
Practice Address - Street 1:106 CHESTNUT ST E # 308
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:MN
Practice Address - Zip Code:55082-5116
Practice Address - Country:US
Practice Address - Phone:651-472-6535
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-02
Last Update Date:2022-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health