Provider Demographics
NPI:1629749791
Name:412 FOSTER PROJECT
Entity Type:Organization
Organization Name:412 FOSTER PROJECT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JENNA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOSI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-874-6015
Mailing Address - Street 1:924 LIMESTONE DR
Mailing Address - Street 2:
Mailing Address - City:ALLISON PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15101-4228
Mailing Address - Country:US
Mailing Address - Phone:412-874-6015
Mailing Address - Fax:
Practice Address - Street 1:561 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:PA
Practice Address - Zip Code:15202-3531
Practice Address - Country:US
Practice Address - Phone:412-874-6015
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-27
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency