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Organization
NEW FOUNDATIONS FOR HEALTHY LIVING,LLC
Active
Organization
NEW FOUNDATIONS FOR HEALTHY LIVING,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SERQUITTO NYCOLE CORNNER MS (PRESIDENT/CEO)
(317) 252-3990
Entity
Organization
Contact information
Practice address
1411 MUTZ DR, INDIANAPOLIS, IN 46229-2250
(317) 252-3990
Mailing address
1411 MUTZ DR, INDIANAPOLIS, IN 46229-2250
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
—
Other
Enumeration date
05/09/2011
Last updated
05/09/2011
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