Organization
WOLFE & JACKSON FAMILY CARE HOME
Active
Parent organization
WOLFE & JACKSON FAMILY CARE HOME
Other names
w & j adult services
Organization subpart
Yes
Provider details
NPI number
Legal business name
WOLFE & JACKSON FAMILY CARE HOME
Authorized official
MRS. ZELMA JACKSON WOLFE (ADMINISTRATOR)
(336) 722-8354
Entity
Organization
Contact information
Practice address
3913 INDIANA AVE, WINSTON SALEM, NC 27105-3410
(336) 661-9032
Mailing address
PO BOX 12002, WINSTON SALEM, NC 27117-2002
(336) 722-8354
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7802068
—
NC
Enumeration date
07/14/2008
Last updated
07/14/2008
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