Organization
SOLID ROOTS FOUNDTION
Active
Organization
SOLID ROOTS FOUNDTION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YANNICK KINSAKA (MANAGER)
(910) 930-2160
Entity
Organization
Contact information
Practice address
219 WINDSOR DR, FAYETTEVILLE, NC 28301-4368
(910) 930-2160
Mailing address
219 WINDSOR DR, FAYETTEVILLE, NC 28301-4368
(910) 930-2160
Taxonomy
Speciality
Code
Description
License number
State
261QR0800X
Recovery Care Clinic/Center
—
—
3104A0625X
Assisted Living Facility (Mental Illness)
—
—
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
Primary
—
—
Other
Enumeration date
07/19/2024
Last updated
07/24/2024
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