Organization · Type 2 NPI

Wolfe & Jackson Group Home, Inc.

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Winston Salem, NC

NPI number 1265758916 Active

Practice location

3913 Indiana Ave
Winston Salem, NC 27105-3410

Call (336) 661-0923 Map

Fax (336) 793-1496

Mailing address

PO Box 4912
Winston Salem, NC 27115-4912

Specialties and licenses

TaxonomyCodeLicense
In Home Supportive Care Agency 253Z00000XNone listed
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary 320900000XMHL 034-254 (NC)

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility: A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.

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About NPI 1265758916

Wolfe & Jackson Group Home, Inc.'s National Provider Identifier is 1265758916, issued on Apr 20, 2010. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Winston Salem, NC. The record was last updated on Jul 25, 2023.