# WHIT RAVEN FAMILY HOME CARE

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

## Provider details

- **NPI number:** 1841165198
- **Authorized official:** RODERICK GIST (OWNER/OPERATOR)
- **Authorized official phone:** (336) 287-8789

## Contact information

- **Practice address:** 203 SNEAD RD, WINSTON SALEM, NC 27103-6830
- **Practice address phone:** (336) 293-6664
- **Mailing address:** 203 SNEAD RD, WINSTON SALEM, NC 27103-6830
- **Mailing address phone:** (336) 293-6664

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA0600X | Adult Day Care Clinic/Center | — | NULL | — |
| 311ZA0620X | Adult Care Home Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 10/07/2025
- **Last updated:** 06/09/2026