Organization
FORIEL HEALTH SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RUBY COOPER (PRESIDENT)
(704) 604-1907
Entity
Organization
Contact information
Practice address
211 S CENTER ST, STATESVILLE, NC 28677-5873
(704) 604-1907
Mailing address
9935D REA RD # 149, CHARLOTTE, NC 28277-6710
(704) 604-1907
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
251X00000X
Supports Brokerage Agency
—
—
252Y00000X
Early Intervention Provider Agency
—
—
261QA0600X
Adult Day Care Clinic/Center
—
—
261QC1500X
Community Health Clinic/Center
—
—
261QH0100X
Health Service Clinic/Center
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
10/28/2024
Last updated
10/28/2024
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