Organization
WOLFE & JACKSON GROUP HOME, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ZELMA JACKSON WOLFE (ADMINISTRATOR, CEO)
(336) 788-3004
Entity
Organization
Contact information
Practice address
744 E SPRAGUE ST, WINSTON SALEM, NC 27107-3246
(336) 788-3004
(336) 529-6454
Mailing address
PO BOX 12002, WINSTON SALEM, NC 27117-2002
(336) 722-8354
(336) 722-8354
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
MHL-034-276
NC
385H00000X
Respite Care
MHL-034-276
NC
Other
Enumeration date
01/18/2010
Last updated
03/08/2024
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