Organization
FOUNDATIONS OF LIFE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TUANQUILLA MONTESSA BROWN BSW (EXECUTIVE DIRECTOR)
(262) 634-8048
Entity
Organization
Contact information
Practice address
835 WISCONSIN AVE, SUITE 104, RACINE, WI 53403-1505
(262) 634-8048
Mailing address
835 WISCONSIN AVE, SUITE 104, RACINE, WI 53403-1505
(262) 634-8048
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
06/15/2009
Last updated
06/15/2009
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