Provider Demographics
NPI:1518162320
Name:SOLID FOUNDATION FACILITIES, INC
Entity Type:Organization
Organization Name:SOLID FOUNDATION FACILITIES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:R
Authorized Official - Middle Name:VERNELL
Authorized Official - Last Name:RODGERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-794-2385
Mailing Address - Street 1:224 WARD RD
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:NC
Mailing Address - Zip Code:27983-9074
Mailing Address - Country:US
Mailing Address - Phone:252-794-2382
Mailing Address - Fax:252-794-1923
Practice Address - Street 1:1313 1ST ST W
Practice Address - Street 2:
Practice Address - City:AHOSKIE
Practice Address - State:NC
Practice Address - Zip Code:27910-8842
Practice Address - Country:US
Practice Address - Phone:252-794-2385
Practice Address - Fax:252-794-1923
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8300760FMedicaid
NC8300760HMedicaid
NC8300760GMedicaid
NC8300760Medicaid
NC8300760JMedicaid
NC8300760IMedicaid
NC8300760BMedicaid