Organization
FOUNDATIONS LC
Active
Organization
FOUNDATIONS LC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FISI MEIMUA MOLENI LCSW (PROGRAM DIRECTOR)
(801) 654-0772
Entity
Organization
Contact information
Practice address
4601 W 3245 S, WEST VALLEY, UT 84120-1523
(801) 654-0772
Mailing address
4601 W 3245 S, WEST VALLEY, UT 84120-1523
(801) 654-0772
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
5843697
UT
Other
Enumeration date
10/20/2007
Last updated
10/20/2007
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