Provider Demographics
NPI:1942536941
Name:THERAPEUTIC FOUNDATIONS
Entity Type:Organization
Organization Name:THERAPEUTIC FOUNDATIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:NAIMOLI
Authorized Official - Suffix:
Authorized Official - Credentials:MA, BCBA
Authorized Official - Phone:386-846-3351
Mailing Address - Street 1:1181 DAL MASO DR
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32117-4109
Mailing Address - Country:US
Mailing Address - Phone:386-846-3351
Mailing Address - Fax:386-226-2076
Practice Address - Street 1:1181 DAL MASO DR
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32117-4109
Practice Address - Country:US
Practice Address - Phone:386-846-3351
Practice Address - Fax:386-226-2076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-26
Last Update Date:2009-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL686174196251C00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No251S00000XAgenciesCommunity/Behavioral Health