Provider Demographics
NPI:1740729581
Name:HEALTHY FOUNDATIONS, LLC
Entity type:Organization
Organization Name:HEALTHY FOUNDATIONS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KURT
Authorized Official - Middle Name:
Authorized Official - Last Name:KOCHES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-970-4011
Mailing Address - Street 1:4350 E WEST HWY STE 200
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-4426
Mailing Address - Country:US
Mailing Address - Phone:301-970-4001
Mailing Address - Fax:301-970-4002
Practice Address - Street 1:4350 EAST WEST HWY
Practice Address - Street 2:STE 200
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814
Practice Address - Country:US
Practice Address - Phone:301-970-4001
Practice Address - Fax:301-970-4002
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HFG HOLDINGS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-02-13
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD261QM0801X, 261QM0850X, 261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health