Organization
FOUNDATION HEALTH SYSTEMS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIN ELIZABETH BALL (MGR REGIONAL REHAB SERVICES)
(704) 316-4443
Entity
Organization
Contact information
Practice address
2085 FRONTIS PLAZA BLVD, WINSTON SALEM, NC 27103-5614
(336) 277-8755
Mailing address
PO BOX 601791, CHARLOTTE, NC 28260-1791
(336) 751-8003
(336) 751-8030
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Enumeration date
10/04/2024
Last updated
12/03/2024
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