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Organization

KWEEN5464 CORPORATION

Active
Parent organization
KWEEN5464 CORPORATION
Other names
At Home Eldercare of Winston Salem
Organization subpart
Yes

Provider details

NPI number
Legal business name
KWEEN5464 CORPORATION
Authorized official
MS. KIMBERLY PETTIGREW (OWNER/DIRECTOR)
(336) 582-9156
Entity
Organization

Contact information

Practice address
1826 E 4TH ST, WINSTON SALEM, NC 27101-4606
(336) 582-9156
(888) 682-1348
Mailing address
PO BOX 561, WINSTON SALEM, NC 27102-0561
(336) 582-9156
(888) 682-1348

Taxonomy

Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary

Other

Enumeration date
04/01/2020
Last updated
08/09/2021
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