NPIMap

Organization Active NPI

Forgotten Mom, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Wellington, FL
National Provider Identifier
1720722945
Registry record updated Apr 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
FORGOTTEN MOM, INC.
Practice address
2574 Treanor Ter
Wellington, FL 33414-6407
Phone
(561) 704-9558
NPI assigned
Apr 25, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2022

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

Authorized official

Name
Dr. Bianca S Gerena, PHD
Title
Administration
Phone
(561) 704-9558

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

2574 Treanor Ter
Wellington, FL 33414-6407

Mailing address

2574 Treanor Ter
Wellington, FL 33414-6407
Phone (561) 704-9558

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1650844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650844800000",
    "number": "1720722945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2574 TREANOR TER",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334146407",
            "telephone_number": "561-704-9558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2574 TREANOR TER",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334146407",
            "telephone_number": "561-704-9558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORGOTTEN MOM, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-25",
        "last_updated": "2022-04-25",
        "certification_date": "2022-04-25",
        "status": "A",
        "authorized_official_last_name": "GERENA",
        "authorized_official_first_name": "BIANCA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "ADMINISTRATION",
        "authorized_official_telephone_number": "561-704-9558",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellington, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.