Organization
WILSON'S CONSTANT CARE, LLC
Active
Other names
Wilson's Constant Care
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KATHERINE NABRENA WILSON (CEO/EXECUTIVE DIRECTOR)
(336) 391-3476
Entity
Organization
Contact information
Practice address
1228 HIGHLAND AVE, WINSTON SALEM, NC 27101-1625
(336) 703-9650
(336) 703-9793
Mailing address
1228 HIGHLAND AVE, WINSTON SALEM, NC 27101-1625
(336) 703-9650
(336) 703-9793
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
251S00000X
Community/Behavioral Health Agency
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
MHL-034-201
NC
385H00000X
Respite Care
—
—
385HR2055X
Child Mental Illness Respite Care
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6604063
—
NC
Enumeration date
11/01/2006
Last updated
08/23/2007
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