Foundations LC

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

License

5843697 Issued in UT

Legal business name

FOUNDATIONS LC

Practice address

4601 W 3245 S
West Valley, UT 84120-1523

Phone

(801) 654-0772

NPI assigned

Oct 20, 2007

Last updated

Oct 20, 2007By 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

Mr. Fisi Meimua Moleni, LCSWNPI 1588622336

Title

Program Director

Phone

(801) 654-0772

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Fisi Meimua Moleni Jr.

  • Mental Health Counselor
  • S Salt Lake, UT
  • NPI 1588622336
  NPD (past) Authorized official

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

{
    "created_epoch": "1192838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192838400000",
    "number": "1881883387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 W 3245 S",
            "city": "WEST VALLEY",
            "state": "UT",
            "postal_code": "841201523",
            "telephone_number": "801-654-0772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4601 W 3245 S",
            "city": "WEST VALLEY",
            "state": "UT",
            "postal_code": "841201523",
            "telephone_number": "801-654-0772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUNDATIONS LC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-20",
        "last_updated": "2007-10-20",
        "status": "A",
        "authorized_official_last_name": "MOLENI",
        "authorized_official_first_name": "FISI",
        "authorized_official_middle_name": "MEIMUA",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "801-654-0772",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "UT",
            "license": "5843697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Illness Community Based Residential Treatment Facility in West Valley, UT
• Providers in West Valley, UT by specialty
• Mental Illness Community Based Residential Treatment Facility in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2007; 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.