Provider Demographics
NPI:1124514716
Name:FOUNDATION SUPPORT SYSTEMS INC
Entity type:Organization
Organization Name:FOUNDATION SUPPORT SYSTEMS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:ADE
Authorized Official - Last Name:TUMA
Authorized Official - Suffix:
Authorized Official - Credentials:MSC
Authorized Official - Phone:352-225-3396
Mailing Address - Street 1:901 NW 8TH AVE
Mailing Address - Street 2:SUITE B-10
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32601
Mailing Address - Country:US
Mailing Address - Phone:352-225-3396
Mailing Address - Fax:
Practice Address - Street 1:901 NW 8TH AVE
Practice Address - Street 2:SUITE B-10
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32601
Practice Address - Country:US
Practice Address - Phone:352-225-3396
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-06
Last Update Date:2018-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251E00000X, 251J00000X, 343900000X, 3140N1450X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3140N1450XNursing & Custodial Care FacilitiesSkilled Nursing FacilityNursing Care, Pediatric
No251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)