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General NPI Number Information
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NPI Number | 1114343159
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Entity Type | Organization
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Legal Business Name | FOUNDATION STONES, INC.
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Dates
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Enumeration Date | 03/14/2014
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Last Update Date | 03/14/2014
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Provider Practice Location Address
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Address Line | 1001 COURT ST
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City | LYNCHBURG
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State | VA
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Zip | 24504-4501
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Country | US
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Telephone | 434-238-5602
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Fax | 434-847-4244
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Provider Business Mailing Address
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Address Line | 1001 COURT ST
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City | LYNCHBURG
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State | VA
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Zip | 24504-4501
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Country | US
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Telephone | 434-238-5602
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Fax | 434-847-4244
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Authorized Official
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Title or Position | CEO
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Name | ERIC J MATTOCKS
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Credential |
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Telephone | 434-238-5602
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 199403001
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License Number State | VA
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