Provider Demographics
NPI:1427896331
Name:NURTURED FOUNDATION, LLC
Entity type:Organization
Organization Name:NURTURED FOUNDATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:FALKENSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-409-5403
Mailing Address - Street 1:1237 HATHAWAY AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44107-2721
Mailing Address - Country:US
Mailing Address - Phone:216-409-5403
Mailing Address - Fax:
Practice Address - Street 1:1237 HATHAWAY AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:OH
Practice Address - Zip Code:44107-2721
Practice Address - Country:US
Practice Address - Phone:216-409-5403
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-16
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care