WOLFE & JACKSON FAMILY CARE HOME (NPI# 1457476913) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457476913 |
| Entity Type | Organization |
| Organization Name | WOLFE & JACKSON FAMILY CARE HOME |
| Practice Address |
744 East Sprague Street Winston Salem NC 27107-3246 |
| Mailing Address |
Po Box 12002 Winston Salem NC 27117-2002 |
| Practice Telephone | 3367228354 |
| Practice Fax Number | 3367228354 |
| Mailing Telephone | 3367228354 |
| Mailing Fax Number | 3367228354 |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2008-07-11 |
| Authorized Official Name | MRS. ZELMA JACKSON WOLFE (ADMINSTATOR) |
| Authorized Official Telephone | 3357228354 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
FCL034020 | NC | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 237701279P | 05 | |
| NC | PROVIDER # | 7802068 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023272663 | Wolfe & Jackson Family Care Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3913 Indiana Ave, Winston Salem, NC 27105-3410 | 2008-07-14 |
| Street Address |
744 EAST SPRAGUE STREET |
| City | WINSTON SALEM |
| State | NC |
| Zip Code | 27107-3246 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154934727 | Sreto Duric | Physical Therapy Assistant | 3863 Robbins Brook Dr, Winston Salem, NC 27107 | 2020-08-24 |
| 1164936852 | Lindsay Webster | Physician Assistant | 10479 Nc-109, 107a, Winston Salem, NC 27107 | 2017-11-17 |
| 1447592209 | Vinson Psychological Services, Pllc | Psychologist | 4236 Sherlie Weavil Rd, Winston Salem, NC 27107 | 2013-03-20 |
| 1629212501 | Benicia Elaine Cleveland | Specialist/Technologist | 1250 S Martin Luther King Jr. Drive, Winston-salem State University, Winston-salem, NC 27107 | 2009-04-23 |
| 1083714364 | Lia Simpson Erickson | Pediatrics | 648 East Monmouth Street, Winston Salem, NC 27107 | 2006-09-25 |
| 1336242973 | North Carolina Cvs Pharmacy LLC | Pharmacy | 10478 N Nc Hwy 109, Wallburg, NC 27107 | 2006-09-07 |
| 1154816312 | Janel Rebecca Durham | Nurse Practitioner | 10479 N Nc Highway 109 Ste 107a, Winston Salem, NC 27107 | 2018-06-28 |
| 1861929523 | Southside United Health Centers | Social Worker | 3009 Waughtown St, Winston Salem, NC 27107 | 2017-05-12 |
| 1407011398 | Ashley Rose Hill | Nurse Practitioner | 648 East Monmouth Street, Winston Salem, NC 27107 | 2008-07-21 |
| 1518157247 | Ellen R. Robinson | Pediatrics | 648 East Monmouth Street, Winston Salem, NC 27107 | 2007-07-30 |
| Find all providers in zip 27107 | ||||
| Taxonomy Code | 311ZA0620X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| Specialization | Adult Care Home |
| A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558661173 | W.e.s. Home Care | Custodial Care Facility | 1288 Cloister Dr, Winston Salem, NC 27127-5608 | 2010-10-29 |
| 1912172198 | Hines Good Samaritan Home | Custodial Care Facility | 2317 Elbon Dr, Winston Salem, NC 27105-5649 | 2008-04-28 |
| 1093991234 | Independent Living Group Home, LLC | Custodial Care Facility | 924 Cloister Dr, Winston Salem, NC 27127 | 2008-01-17 |
| 1245357052 | Velma Hines Foster | Custodial Care Facility | 3171 Carver School Rd, Winston Salem, NC 27105-4750 | 2007-03-25 |
| 1255456380 | Margaretta Hines Moore | Custodial Care Facility | 2224 Manchester St, Winston Salem, NC 27105-5536 | 2007-03-20 |
| 1427149434 | Springwell Network, Inc. | Custodial Care Facility | 2588 Brandywine Road, Winston Salem, NC 27103-6602 | 2006-09-27 |
| 1780889022 | Kindred Hearts Adult Care Home | Custodial Care Facility | 3171 Carver School Rd, Winston Salem, NC 27105-4750 | 2007-06-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578162061 | Lewis E Williams | Custodial Care Facility | 1640 Bridgedale Dr, Rocky Mount, NC 27803-1604 | 2020-10-26 |
| 1861008583 | Arbor Landing At Hampstead LLC | Custodial Care Facility | 13937 Us Highway 17, Hampstead, NC 28443-4041 | 2020-09-17 |
| 1124645544 | Charlotte Sp Senior Housing Opco, LLC | Custodial Care Facility | 6041 Piedmont Row Drive, Charlotte, NC 28208 | 2020-07-01 |
| 1740804111 | Happy Hearts Group Home | Custodial Care Facility | 6255 Burlington Rd, Gibsonville, NC 27249-8783 | 2020-06-02 |
| 1730703422 | Graham 4 Enterprises | Custodial Care Facility | 3006 W Sedgefield Dr, Greensboro, NC 27407-7313 | 2020-05-29 |
| 1477177111 | C&s Adult Care LLC, Dba Deal Care Inn | Custodial Care Facility | 1075 Deal Rd, Mooresville, NC 28115-6719 | 2020-05-28 |
| 1114554516 | Cassandra Davis | Custodial Care Facility | 131 Huntington Rd, Louisburg, NC 27549 | 2020-03-25 |
| 1356975767 | Cornerstone Community Service | Custodial Care Facility | 2220 Southgate St, Durham, NC 27703-2102 | 2020-02-24 |
| 1477184653 | Rose Vista Assisted Living, LLC | Custodial Care Facility | 2130 Rose Vista Rd, Kinston, NC 28504-8230 | 2020-01-28 |
| 1104456011 | Regina Williams | Custodial Care Facility | 511 Tansy Drive, Charlotte, NC 28214 | 2020-01-20 |
| Find all providers with the same taxonomy | ||||
| City | WINSTON SALEM |
| Zip Code | 27107 |
Please comment or provide details below to improve the information on WOLFE & JACKSON FAMILY CARE HOME.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.