Provider Demographics
NPI:1447484423
Name:A SOLID FOUNDATION
Entity type:Organization
Organization Name:A SOLID FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:TORAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-264-3529
Mailing Address - Street 1:420 CAMERON STREET
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-5912
Mailing Address - Country:US
Mailing Address - Phone:336-264-3529
Mailing Address - Fax:
Practice Address - Street 1:420 CAMERON STREET
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-5912
Practice Address - Country:US
Practice Address - Phone:336-264-3529
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-06
Last Update Date:2009-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL-001-182261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health