Provider Demographics
NPI:1487659900
Name:FOUNDATIONS HEALTH SYSTEMS CORP
Entity Type:Organization
Organization Name:FOUNDATIONS HEALTH SYSTEMS CORP
Other - Org Name:THE OAKS AT FORSYTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EVP CFO
Authorized Official - Prefix:
Authorized Official - First Name:FRED
Authorized Official - Middle Name:M
Authorized Official - Last Name:HARGETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-384-5184
Mailing Address - Street 1:901 BETHESDA ROAD
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-3015
Mailing Address - Country:US
Mailing Address - Phone:336-768-2211
Mailing Address - Fax:336-774-6545
Practice Address - Street 1:901 BETHESDA ROAD
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-3015
Practice Address - Country:US
Practice Address - Phone:336-768-2211
Practice Address - Fax:336-774-6545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-21
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNH0439314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3406435Medicaid
NC5250OtherPARTNERS MEDICARE CHOICE
NC3405284Medicaid
NC0095NOtherBLUE CROSS BLUE SHIELD
NC3405284Medicaid
NC0527650003Medicare NSC