Healthcare Provider Details

I. General information

NPI: 1083785968
Provider Name (Legal Business Name): FOLTS HOMES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 10/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 N WASHINGTON ST
HERKIMER NY
13350-2028
US

IV. Provider business mailing address

104 N WASHINGTON ST
HERKIMER NY
13350-2028
US

V. Phone/Fax

Practice location:
  • Phone: 315-866-6964
  • Fax: 315-866-6760
Mailing address:
  • Phone: 315-866-6964
  • Fax: 315-866-6760

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. RALPH P REID
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 315-866-6964