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Organization
SOLID FOUNDATION FACILITIES INCORPORATED
Active
Organization
SOLID FOUNDATION FACILITIES INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. R. VERNELL RODGERS (CEO PRESIDENT)
(252) 794-2385
Entity
Organization
Contact information
Practice address
208 DUNDEE ST, WINDSOR, NC 27983-6701
(252) 794-4800
(252) 794-4747
Mailing address
PO BOX 709, 224 WARD ROAD, WINDSOR, NC 27983-0709
(252) 794-2385
(252) 794-1923
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
626
NC
103T00000X
Psychologist
626
NC
1041C0700X
Clinical Social Worker
626
NC
106H00000X
Marriage & Family Therapist
626
NC
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
232104
MEDICARE PTAN
NC
05
—
3408848
—
NC
05
—
5906030
—
NC
05
—
6005687
—
NC
05
—
8300759B
—
NC
05
—
8300759H
—
NC
05
—
8300760
—
NC
05
—
8300760H
—
NC
Enumeration date
10/19/2006
Last updated
03/14/2008
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