Organization
HINES FAMILY SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DERRICK HINES (CEO)
(469) 353-9526
Entity
Organization
Contact information
Practice address
615 SAINT GEORGE SQUARE CT STE 300, WINSTON SALEM, NC 27103-1368
(336) 303-1263
Mailing address
615 SAINT GEORGE SQUARE CT STE 300, WINSTON SALEM, NC 27103-1368
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
01/28/2020
Last updated
07/28/2020
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