Organization
C&G GROUP HOME, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. YVONNE CHEEKS PH.D (PRESIDENT)
(336) 655-7831
Entity
Organization
Contact information
Practice address
508 E 15TH ST, WINSTON SALEM, NC 27105-6161
(336) 655-7831
(336) 661-3059
Mailing address
6010 SUMMER TRACE LN, WINSTON SALEM, NC 27105-9124
(336) 655-7831
(336) 661-3059
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
374U00000X
Home Health Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1861231557
—
NC
Enumeration date
01/17/2023
Last updated
05/23/2024
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