Provider Demographics
NPI:1639507676
Name:HINDS' FEETFARM, LLC
Entity Type:Organization
Organization Name:HINDS' FEETFARM, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:B
Authorized Official - Last Name:FOIL
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:704-992-1424
Mailing Address - Street 1:PO BOX 2842
Mailing Address - Street 2:
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28070-2842
Mailing Address - Country:US
Mailing Address - Phone:704-992-1424
Mailing Address - Fax:704-992-1423
Practice Address - Street 1:14645 BLACK FARMS RD
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078
Practice Address - Country:US
Practice Address - Phone:704-992-1424
Practice Address - Fax:704-992-1423
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-30
Last Update Date:2013-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL-060-1257320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities