# FOSTER4LOVE INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Healing Moments
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114428695
- **Authorized official:** JENNIFER COURTNEY MOODY (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (770) 558-5491

## Contact information

- **Practice address:** 3745 CHEROKEE ST NW STE 602, KENNESAW, GA 30144-6785
- **Practice address phone:** (770) 558-5491
- **Mailing address:** 4393 LAURIAN DR NW, KENNESAW, GA 30144-5147
- **Mailing address phone:** (770) 558-5491

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 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 | — | NULL | Yes |

## Other

- **Enumeration date:** 02/21/2018
- **Last updated:** 05/29/2019