Organization
WAGNER & WILSON ENTERPRISES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHERIE' WAGNER (CO- OWNER/EXECUTIVE DIRECTOR)
(704) 771-0985
Entity
Organization
Contact information
Practice address
1911 WILLIMAX AVE, GASTONIA, NC 28054-7440
(704) 771-0985
Mailing address
938 GLENCOE ST, WINSTON SALEM, NC 27107-3315
(704) 771-0985
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
06/06/2024
Last updated
06/13/2024
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