Organization
PROVISIONS OF THE HEARTS, DBA FOUNDATIONS OP GROUP
Active
Organization
PROVISIONS OF THE HEARTS, DBA FOUNDATIONS OP GROUP
Active
Other names
FOUNDATIONS OP GROUP
Organization subpart
No
Provider details
NPI number
Authorized official
MECHAC TRICE JOHNSON (MANAGING OWNER)
(954) 709-5570
Entity
Organization
Contact information
Practice address
999 W PROSPECT RD, OAKLAND PARK, FL 33309-4634
(954) 709-5570
Mailing address
999 W PROSPECT RD, OAKLAND PARK, FL 33309-4634
(954) 709-5570
Taxonomy
Speciality
Code
Description
License number
State
225C00000X
Rehabilitation Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1205270865
INDIVIDUAL NPI
FL
Enumeration date
10/30/2018
Last updated
10/30/2018
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