Organization
C&W ALTERNATIVE FAMILY LIVING FACILITY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARSHALL ELMORE MS., QP. (ADMINISTRATOR)
(336) 723-3829
Entity
Organization
Contact information
Practice address
3365 NEW WALKERTOWN RD, WINSTON SALEM, NC 27105-4160
(336) 723-3829
(336) 723-3829
Mailing address
3365 NEW WALKERTOWN RD, WINSTON SALEM, NC 27105-4160
(336) 723-3829
(336) 723-3829
Taxonomy
Speciality
Code
Description
License number
State
310500000X
Mental Illness Intermediate Care Facility
Primary
MHL- 034-160
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8301339
—
NC
Enumeration date
03/29/2007
Last updated
08/22/2020
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