Provider Demographics
NPI:1144931601
Name:FOSTERING COMMUNITIES
Entity type:Organization
Organization Name:FOSTERING COMMUNITIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO, CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:GENER
Authorized Official - Middle Name:ESTRADA
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC
Authorized Official - Phone:417-658-5409
Mailing Address - Street 1:3871 S SUBURBAN
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65807
Mailing Address - Country:US
Mailing Address - Phone:417-658-5408
Mailing Address - Fax:
Practice Address - Street 1:836 S SUBURBAN AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65802-6774
Practice Address - Country:US
Practice Address - Phone:417-658-5409
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-06
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health