# WTB NEW VISION INC.

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

## Provider details

- **NPI number:** 1982783049
- **Authorized official:** MR. BRIAN HAIRSTON (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (336) 723-7707

## Contact information

- **Practice address:** 102 W 3RD ST, SUITE 502, WINSTON SALEM, NC 27101-3940
- **Practice address phone:** (336) 723-7707
- **Practice address fax:** (336) 723-7708
- **Mailing address:** 102 W 3RD ST, SUITE 502, WINSTON SALEM, NC 27101-3987
- **Mailing address phone:** (336) 723-7707
- **Mailing address fax:** (336) 723-7708

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | MHL-034-170 | NC | Yes |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | MHL-034-185 | NC | — |

## Other

- **Enumeration date:** 11/02/2006
- **Last updated:** 06/06/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 6603536 | — | NC |
| 05 | — | 6603924 | — | NC |
| 05 | — | 6604170 | — | NC |
| 05 | — | 8300791 | — | NC |
| 05 | — | 8300791B | — | NC |
| 05 | — | 8300791G | — | NC |