Organization
SOLID FOUNDATION FACILITIES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
R VERNELL RODGERS (CEO)
(252) 794-2385
Entity
Organization
Contact information
Practice address
1321 FIRST ST W, AHOSKIE, NC 27910-8842
(252) 209-8932
(252) 209-8933
Mailing address
PO BOX 709, WINDSOR, NC 27983-0709
(252) 794-2385
(252) 794-4747
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
626
NC
1041C0700X
Clinical Social Worker
626
NC
251B00000X
Case Management Agency
—
NC
251S00000X
Community/Behavioral Health Agency
626
NC
253Z00000X
In Home Supportive Care Agency
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8300759V
—
NC
05
—
8300760H
—
NC
05
—
8302968D
—
NC
05
—
8302968S
—
NC
05
—
8703090
—
NC
Enumeration date
11/09/2010
Last updated
01/13/2011
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