Foundations Wellness Center LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

5601 Issued in FL

Legal business name

FOUNDATIONS WELLNESS CENTER LLC

Practice address

160 NW Central Park PLZ Ste 110
Port St Lucie, FL 34986-1825

Phone

(772) 812-6852

NPI assigned

Apr 1, 2016

Last updated

Jul 21, 2022By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Travis Thames

Title

Ceo

Phone

(772) 361-6778

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1459468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1194188656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 NW CENTRAL PARK PLZ STE 110",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349861825",
            "telephone_number": "772-812-6852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 NW CENTRAL PARK PLZ STE 110",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349861825",
            "telephone_number": "772-812-6852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUNDATIONS WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-01",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "THAMES",
        "authorized_official_first_name": "TRAVIS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "772-361-6778"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "FL",
            "license": "5601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lissa Forestal
• Stephanie Catherine Forrest, HAS
• Robert I Forster, MD
• Anne Foster, PT
• Carolyn Foster, APRN, PMHNP-BC
• Alyssa Ann Fox
• Chelsea Ann Foy, PA
• Cam Tu Francescone, PA
• Gregory Scott Francis, DO
• Khalidah Francis

• Substance Abuse Rehabilitation Facility in Port St Lucie, FL
• Providers in Port St Lucie, FL by specialty
• Substance Abuse Rehabilitation Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.