Provider Demographics
NPI:1366560591
Name:FAMILY FOUNDATIONS LLC
Entity type:Organization
Organization Name:FAMILY FOUNDATIONS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:BENJAMIN
Authorized Official - Last Name:TOTORA
Authorized Official - Suffix:JR
Authorized Official - Credentials:LPC, LMFT
Authorized Official - Phone:609-457-3344
Mailing Address - Street 1:BOX 160
Mailing Address - Street 2:
Mailing Address - City:MAYS LANDING
Mailing Address - State:NJ
Mailing Address - Zip Code:08330-1511
Mailing Address - Country:US
Mailing Address - Phone:609-457-3344
Mailing Address - Fax:609-567-5923
Practice Address - Street 1:1161 CAPE MAY AVENUE
Practice Address - Street 2:SUITE A
Practice Address - City:MAYS LANDING
Practice Address - State:NJ
Practice Address - Zip Code:08330-1511
Practice Address - Country:US
Practice Address - Phone:609-457-3344
Practice Address - Fax:609-567-5923
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2017-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJPC 02392101YP2500X
NJ44SC051839001041C0700X
NJFI 01398106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
458991000OtherMAGELLAN MIS #