# WILSON COUNTY RESIDENTIAL SERVICES, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346370160
- **Authorized official:** GALE PUEVIS (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (252) 237-4778

## Contact information

- **Practice address:** 1300 GOLD ST N, WILSON, NC 27893-2302
- **Practice address phone:** (252) 237-4778
- **Practice address fax:** (252) 206-1681
- **Mailing address:** 115 B WEST HINES ST, WILSON, NC 27893-3924
- **Mailing address phone:** (252) 237-4778
- **Mailing address fax:** (252) 206-1681

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | MHL-098-079 | NC | Yes |

## Other

- **Enumeration date:** 03/07/2007
- **Last updated:** 08/22/2020