Provider Demographics
NPI:1962035105
Name:FOUNDATION HEALTH LLC
Entity Type:Organization
Organization Name:FOUNDATION HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:804-833-6617
Mailing Address - Street 1:PO BOX 5998
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20824-5998
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7801 NORFOLK AVE
Practice Address - Street 2:T SUITE
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-6015
Practice Address - Country:US
Practice Address - Phone:301-664-4710
Practice Address - Fax:301-338-6450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-17
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty