Provider Demographics
NPI:1952590416
Name:FOUNDATION REHAB, INC.
Entity Type:Organization
Organization Name:FOUNDATION REHAB, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:LAUDER
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:301-463-5038
Mailing Address - Street 1:PO BOX 102
Mailing Address - Street 2:
Mailing Address - City:LONACONING
Mailing Address - State:MD
Mailing Address - Zip Code:21539-0102
Mailing Address - Country:US
Mailing Address - Phone:301-463-5038
Mailing Address - Fax:301-463-5426
Practice Address - Street 1:57 JACKSON ST
Practice Address - Street 2:
Practice Address - City:LONACONING
Practice Address - State:MD
Practice Address - Zip Code:21539-1307
Practice Address - Country:US
Practice Address - Phone:301-463-5451
Practice Address - Fax:301-463-5456
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-22
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy