Organization
WOLFE & JACKSON GROUP HOME, INC.
Active
Organization
WOLFE & JACKSON GROUP HOME, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ZELMA JACKSON- WOLFE (EXECUTIVE DIRECTOR)
(336) 749-7660
Entity
Organization
Contact information
Practice address
3913 INDIANA AVE, WINSTON SALEM, NC 27105-3410
(336) 661-0923
(336) 793-1496
Mailing address
PO BOX 4912, WINSTON SALEM, NC 27115-4912
(336) 245-0303
(336) 722-8354
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
MHL 034-254
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3419271
—
NC
Enumeration date
04/20/2010
Last updated
07/25/2023
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