Organization
FOUNDATIONS OF COMMUNITY LIVING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TARA P TAYLOR LPC (OWNER)
(920) 912-7749
Entity
Organization
Contact information
Practice address
1221 ERIE AVE, SHEBOYGAN, WI 53081-3384
(920) 912-7749
Mailing address
618 ROOSEVELT RD, KOHLER, WI 53044-1618
(920) 912-7749
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
01/27/2022
Last updated
01/27/2022
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