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Organization
WAKE FOREST UNIVERSITY HEALTH SCIENCES
Active
Organization
WAKE FOREST UNIVERSITY HEALTH SCIENCES
Active
Parent organization
WAKE FOREST UNIVERSITY HEALTH SCIENCES
Other names
Amos Cottage Therapeutic Day Program
Organization subpart
Yes
Provider details
NPI number
Legal business name
WAKE FOREST UNIVERSITY HEALTH SCIENCES
Authorized official
DR. WILLIAM B. APPLEGATE MD (PRESIDENT)
(336) 716-4424
Entity
Organization
Contact information
Practice address
3325 SILAS CREEK PKWY, WINSTON SALEM, NC 27103-3013
(336) 713-7443
(336) 713-7850
Mailing address
3325 SILAS CREEK PKWY, WINSTON SALEM, NC 27103-3013
(336) 713-7443
(336) 713-7850
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
MHL034159
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00391
BCBS
NC
05
—
8301291
—
NC
Enumeration date
11/10/2010
Last updated
11/10/2010
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