OrganizationActive
Foundations for Life Clinic LLC
NPI 1285356360 · Speech-Language Pathologist · Lakeside, OR
Provider details
- NPI number
- 1285356360
- Entity type
- Organization
- Primary specialty
- Speech-Language PathologistSpeech, Language and Hearing Service Providers
- Organization subpart
- No
- Authorized official
- Mary Manzano, Member(737) 787-7367
Specialties & taxonomies
Speech, Language and Hearing Service Providers
Profile Score
Established profile(60/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
70909 Devore Arm Rd
Lakeside, OR 97449-8502
Phone: (737) 787-7367
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 242
Lakeside, OR 97449-0242
Other names (DBA / former)
- Doing business as
- Manzano Speech Therapy
Registry dates
- Enumerated
- 2022-09-14
- Last updated
- 2022-09-14
- Certified
- 2022-09-14
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.