Organization
WOLFE & JACKSON FAMILY CARE HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ZELMA JACKSON WOLFE (ADMINSTATOR)
(335) 722-8354
Entity
Organization
Contact information
Practice address
744 EAST SPRAGUE STREET, WINSTON SALEM, NC 27107-3246
(336) 722-8354
(336) 722-8354
Mailing address
PO BOX 12002, WINSTON SALEM, NC 27117-2002
(336) 722-8354
(336) 722-8354
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
FCL034020
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
237701279P
—
NC
01
—
7802068
PROVIDER #
NC
Enumeration date
03/20/2007
Last updated
07/11/2008
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