Provider Demographics
NPI:1316151319
Name:FOUNDATIONS DEVELOPMENTAL HOUSE
Entity type:Organization
Organization Name:FOUNDATIONS DEVELOPMENTAL HOUSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SLP
Authorized Official - Prefix:
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:NOEL
Authorized Official - Last Name:CARAHALY
Authorized Official - Suffix:
Authorized Official - Credentials:MA CCC, SLP
Authorized Official - Phone:480-636-1920
Mailing Address - Street 1:8422 E SHEA BLVD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-6661
Mailing Address - Country:US
Mailing Address - Phone:480-636-1920
Mailing Address - Fax:480-636-1922
Practice Address - Street 1:8422 E SHEA BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-6661
Practice Address - Country:US
Practice Address - Phone:480-636-1920
Practice Address - Fax:480-636-1922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP4221235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty