Provider Demographics
NPI:1477849966
Name:FOSTER'S CARE FACILITY
Entity Type:Organization
Organization Name:FOSTER'S CARE FACILITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:FOSTER
Authorized Official - Middle Name:L
Authorized Official - Last Name:WILKINS
Authorized Official - Suffix:
Authorized Official - Credentials:MS ED
Authorized Official - Phone:336-254-7303
Mailing Address - Street 1:1320 HAMILTON PLACE
Mailing Address - Street 2:SUITE 107
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-4868
Mailing Address - Country:US
Mailing Address - Phone:336-885-0602
Mailing Address - Fax:336-885-0603
Practice Address - Street 1:1320 N. HAMILTON STREET
Practice Address - Street 2:STE 107
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-4868
Practice Address - Country:US
Practice Address - Phone:336-885-0602
Practice Address - Fax:336-885-0603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-22
Last Update Date:2018-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC4363251E00000X, 251K00000X, 253Z00000X
251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251E00000XAgenciesHome Health
No251K00000XAgenciesPublic Health or Welfare
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1679699565Medicaid