Organization
WILSON COUNTY RESIDENTIAL SERVICES
Active
Organization
WILSON COUNTY RESIDENTIAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GALE PURVIS (EXECUTIVE DIRECTOR)
(252) 237-4778
Entity
Organization
Contact information
Practice address
115B HINES ST W, WILSON, NC 27893-3924
(252) 237-4778
(252) 206-1681
Mailing address
115B HINES ST W, WILSON, NC 27893-3924
(252) 237-4778
(252) 206-1681
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
WG000151
SCATTERED SITES
NC
Enumeration date
04/18/2007
Last updated
08/22/2020
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