Forever Changed Foundation

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

FOREVER CHANGED FOUNDATION

Practice address

7804 Yakima Ave
Tacoma, WA 98408-5317

Phone

(253) 765-1713

NPI assigned

Nov 8, 2021

Organization subpart

No

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

Authorized official

Name

Tina Vaughn, RCNPI 1073284204

Title

Director

Phone

(253) 282-0262

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tina Vaughn

  • Case Management Agency
  • Tacoma, WA
  • NPI 1073284204
  NPD Authorized official

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

{
    "created_epoch": "1636329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636329600000",
    "number": "1760147375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7804 YAKIMA AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984085317",
            "telephone_number": "253-765-1713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7804 YAKIMA AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984085317",
            "telephone_number": "253-765-1713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOREVER CHANGED FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-08",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A",
        "authorized_official_last_name": "VAUGHN",
        "authorized_official_first_name": "TINA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "253-282-0262",
        "authorized_official_credential": "RC"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1073284204",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Terrie M Ford, MS ARNP
• Amira Fordham Erickson, MA, MED, LMFTA
• Khalila Fordham, PSYD
• Teresa A. Fordyce, PA-C
• Webster Wyatt Foreman III, L.M.T.
• Selena Ann Forgey, LMP
• Clinton James Foriska, DO
• Melissa Anne Forouhar, MD
• Samantha Forsberg
• Elizabeth A Forseth

• Case Management Agency in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Case Management Agency in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2021; 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.