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Organization
FOSTER4LOVE INC.
Active
Organization
FOSTER4LOVE INC.
Active
Other names
Healing Moments
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER COURTNEY MOODY (EXECUTIVE DIRECTOR)
(770) 558-5491
Entity
Organization
Contact information
Practice address
3745 CHEROKEE ST NW STE 602, KENNESAW, GA 30144-6785
(770) 558-5491
Mailing address
4393 LAURIAN DR NW, KENNESAW, GA 30144-5147
(770) 558-5491
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
NULL
101YM0800X
Mental Health Counselor
—
—
208000000X
Pediatrics Physician
—
NULL
208000000X
Pediatrics Physician
—
—
2080P0006X
Developmental - Behavioral Pediatrics Physician
—
NULL
2080P0006X
Developmental - Behavioral Pediatrics Physician
—
—
225X00000X
Occupational Therapist
—
NULL
225X00000X
Occupational Therapist
—
—
261QH0700X
Hearing and Speech Clinic/Center
—
NULL
261QP2000X
Physical Therapy Clinic/Center
—
NULL
261QX0100X
Occupational Medicine Clinic/Center
Primary
—
NULL
Other
Enumeration date
02/21/2018
Last updated
05/29/2019
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