| Foundation 2, Inc | |
|
1714 Johnson Ave Nw Cedar Rapids IA 52405-4865 | |
| (319) 362-1170 | |
| (319) 297-7406 |
| Full Name | Foundation 2, Inc |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 1714 Johnson Ave Nw, Cedar Rapids, Iowa |
| Authorized Official Name and Position | Patricia Gilbaugh (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3193621170 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Foundation 2, Inc 1714 Johnson Ave Nw Cedar Rapids IA 52405-4865 Ph: (319) 362-1170 | Foundation 2, Inc 1714 Johnson Ave Nw Cedar Rapids IA 52405-4865 Ph: (319) 362-1170 |
| NPI Number | 1881741593 |
|---|---|
| Provider Enumeration Date | 01/04/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881741593 | NPI | - | NPPES |
| 1103135 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | 1103135 (Iowa) | Primary |
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