Provider Demographics
NPI:1962084236
Name:THE FOUNDATION BEHAVIORAL SERVICES
Entity type:Organization
Organization Name:THE FOUNDATION BEHAVIORAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HITTLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-523-7573
Mailing Address - Street 1:2 JAMES CIR
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501-6805
Mailing Address - Country:US
Mailing Address - Phone:303-523-7573
Mailing Address - Fax:
Practice Address - Street 1:2 JAMES CIR
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-6805
Practice Address - Country:US
Practice Address - Phone:303-523-7573
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-26
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental HealthGroup - Single Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty