Provider Demographics
NPI:1306385232
Name:NORKRIS FOUNDATION INC.
Entity Type:Organization
Organization Name:NORKRIS FOUNDATION INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AUDREY
Authorized Official - Middle Name:
Authorized Official - Last Name:FORKA
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:443-526-6133
Mailing Address - Street 1:611 S UNION AVE
Mailing Address - Street 2:
Mailing Address - City:HAVRE DE GRACE
Mailing Address - State:MD
Mailing Address - Zip Code:21078-3421
Mailing Address - Country:US
Mailing Address - Phone:443-526-6133
Mailing Address - Fax:443-526-6134
Practice Address - Street 1:611 S UNION AVE
Practice Address - Street 2:
Practice Address - City:HAVRE DE GRACE
Practice Address - State:MD
Practice Address - Zip Code:21078-3421
Practice Address - Country:US
Practice Address - Phone:443-526-6133
Practice Address - Fax:443-526-6134
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORKRIS SERVICES, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-02-12
Last Update Date:2020-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR219171251S00000X, 251V00000X
261QM0801X, 261QM0850X, 261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251S00000XAgenciesCommunity/Behavioral Health
No251V00000XAgenciesVoluntary or Charitable
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health