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Organization
WILSON'S CONSTANT CARE, LLC
Active
Organization
WILSON'S CONSTANT CARE, LLC
Active
Other names
Wilson's Constant Care
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KATHERINE NABRENA WILSON (CEO/EXECUTIVE DIRECTOR)
(336) 391-3476
Entity
Organization
Contact information
Practice address
1228 HIGHLAND AVE, WINSTON SALEM, NC 27101-1625
(336) 703-9650
(336) 703-9793
Mailing address
1228 HIGHLAND AVE, WINSTON SALEM, NC 27101-1625
(336) 703-9650
(336) 703-9793
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
251S00000X
Community/Behavioral Health Agency
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
MHL-034-201
NC
385H00000X
Respite Care
—
—
385HR2055X
Child Mental Illness Respite Care
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6604063
—
NC
Enumeration date
11/01/2006
Last updated
08/23/2007
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