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General NPI Number Information
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NPI Number | 1417865684
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Entity Type | Organization
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Legal Business Name | THE FOUNDRY
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Dates
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Enumeration Date | 08/31/2026
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Last Update Date | 08/31/2026
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Provider Practice Location Address
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Address Line | 10809 PARRISH ST APT 215
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City | MATTHEWS
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State | NC
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Zip | 28105-8939
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Country | US
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Telephone | 267-721-0926
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Fax |
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Provider Business Mailing Address
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Address Line | 2217 MATTHEWS TOWNSHIP PKWY STE D
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City | MATTHEWS
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State | NC
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Zip | 28105-4819
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Country | US
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Telephone | 267-721-0926
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Fax |
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Authorized Official
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Title or Position | FOUNDRY
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Name | MS. DIANNE F THOMAS
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Credential | ADEBONOJO
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Telephone | 267-721-0926
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number |
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License Number State |
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