| Foundations Pediatrics Assessment And Treatment Center | |
|
495 Prosperity Lake Dr Ste 101 Saint Augustine FL 32092-5045 | |
| (954) 895-3006 | |
| Not Available |
| Full Name | Foundations Pediatrics Assessment And Treatment Center |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 495 Prosperity Lake Dr Ste 101, Saint Augustine, Florida |
| Authorized Official Name and Position | Jillene Driest (OWNER) |
| Authorized Official Contact | 9548953006 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Foundations Pediatrics Assessment And Treatment Center 495 Prosperity Lake Dr Ste 101 Saint Augustine FL 32092-5045 Ph: (954) 895-3006 | Foundations Pediatrics Assessment And Treatment Center 495 Prosperity Lake Dr Ste 101 Saint Augustine FL 32092-5045 Ph: (954) 895-3006 |
| NPI Number | 1841649241 |
|---|---|
| Provider Enumeration Date | 06/07/2016 |
| Last Update Date | 04/16/2024 |
| Certification Date | 04/16/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841649241 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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