Provider Demographics
NPI:1770144594
Name:FOUNDATIONS PEDIATRIC THERAPY
Entity type:Organization
Organization Name:FOUNDATIONS PEDIATRIC THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST/CEO
Authorized Official - Prefix:
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:BARNES
Authorized Official - Last Name:HELMS
Authorized Official - Suffix:
Authorized Official - Credentials:OTD
Authorized Official - Phone:334-313-4844
Mailing Address - Street 1:324 POWDER HORN DR
Mailing Address - Street 2:
Mailing Address - City:MIDLAND CITY
Mailing Address - State:AL
Mailing Address - Zip Code:36350-7024
Mailing Address - Country:US
Mailing Address - Phone:334-313-4844
Mailing Address - Fax:
Practice Address - Street 1:118 ADRIS PL
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36303-1997
Practice Address - Country:US
Practice Address - Phone:334-677-6360
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-24
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation