| Foundation X Llc | |
|
3084 Westfork Dr Ste C Baton Rouge LA 70816-2254 | |
| (318) 489-0781 | |
| Not Available |
| Full Name | Foundation X Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 3084 Westfork Dr Ste C, Baton Rouge, Louisiana |
| Authorized Official Name and Position | Kenny Alexander Houston (CEO) |
| Authorized Official Contact | 3184890781 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Foundation X Llc 3084 Westfork Dr Ste C Baton Rouge LA 70816-2254 Ph: (318) 489-0781 | Foundation X Llc 3084 Westfork Dr Ste C Baton Rouge LA 70816-2254 Ph: (318) 489-0781 |
| NPI Number | 1942078456 |
|---|---|
| Provider Enumeration Date | 12/13/2023 |
| Last Update Date | 04/30/2024 |
| Certification Date | 04/30/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942078456 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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