Provider Demographics
NPI:1255925467
Name:FOUNDATIONS, LLC
Entity type:Organization
Organization Name:FOUNDATIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CLANCY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-326-6006
Mailing Address - Street 1:800 FALMOUTH RD UNIT 201B204B
Mailing Address - Street 2:
Mailing Address - City:MASHPEE
Mailing Address - State:MA
Mailing Address - Zip Code:02649-3303
Mailing Address - Country:US
Mailing Address - Phone:508-326-6006
Mailing Address - Fax:
Practice Address - Street 1:800 FALMOUTH RD UNIT 201B204B
Practice Address - Street 2:
Practice Address - City:MASHPEE
Practice Address - State:MA
Practice Address - Zip Code:02649-3303
Practice Address - Country:US
Practice Address - Phone:508-326-6006
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-28
Last Update Date:2021-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility