WOLFE & JACKSON GROUP HOME, INC. (NPI# 1265758916) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265758916 |
| Entity Type | Organization |
| Organization Name | WOLFE & JACKSON GROUP HOME, INC. |
| Practice Address |
3913 Indiana Ave Winston Salem NC 27105-3410 |
| Mailing Address |
Po Box 4912 Winston Salem NC 27115-4912 |
| Practice Telephone | 3366610923 |
| Practice Fax Number | 3367931496 |
| Mailing Telephone | 3362450303 |
| Mailing Fax Number | 3367228354 |
| Enumeration Date | 2010-04-20 |
| Last Update Date | 2017-04-29 |
| Authorized Official Name | MRS. ZELMA JACKSON- WOLFE (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 3367497660 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | MHL 034-254 | NC | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 3419271 | 05 |
| Street Address |
3913 INDIANA AVE |
| City | WINSTON SALEM |
| State | NC |
| Zip Code | 27105-3410 |
| 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 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346711827 | Allison Colette Steinhaus | Counselor | 8025 Northpoint Blvd, Winston Salem, NC 27105 | 2018-12-10 |
| 1033600382 | Alterman & Dhillon Piedmont, Pplc | Dentist | 336 E Hanes Mill Rd, Winston Salem, NC 27105 | 2018-05-22 |
| 1336676030 | Goldsmith Quality Care LLC. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 132 Jazer Ln, Winston Salem, NC 27105 | 2017-05-12 |
| 1427459981 | Tammy Bartlett | Physical Therapy Assistant | 4850 Sandusky St., Winston Salem, NC 27105 | 2014-09-15 |
| 1194154229 | Marla C Torrence | Counselor | 4140 N. Cherry Street, Winston Salem, NC 27105 | 2013-11-08 |
| 1629313051 | Lydia L. Barber | Counselor | 420 Forest Hills Ave, Winston Salem, NC 27105 | 2012-12-12 |
| 1023362530 | Helen Doby Martin | Home Health Aide | 4782 Butchwood Drive, Winston-salem, NC 27105 | 2012-11-06 |
| 1740545284 | Hines Good Samaritan Home | Technician | 2219 Manchester St., Winston-salem, NC 27105 | 2012-07-11 |
| 1043518129 | Alda Petra Bernardez | Pharmacist | 3539 Patterson Avenue, Winston Salem, NC 27105 | 2011-03-14 |
| 1225336449 | Alia Khaled Al-asfar | Pharmacist | 3539 Patterson Avenue., Winston Salem, NC 27105 | 2011-03-11 |
| Find all providers in zip 27105 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558736066 | Wescare Professional Services, LLC. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1716 Hawkcrest Ln, Winston Salem, NC 27127-4869 | 2015-12-09 |
| 1548411721 | Restorations Behavioral Health Services | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4625 Craver Woods Ct., Winston Salem, NC 27127-8922 | 2008-10-06 |
| 1215024682 | Climbing Jacobs Ladder LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3401 Healy Dr, Suite-b, Winston Salem, NC 27103-1450 | 2006-10-06 |
| 1932215886 | J. L. Redford, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1922 Martin Luther King, Jr. Drive, Winston Salem, NC 27107-1361 | 2006-08-22 |
| 1013107143 | My Sister's Place Community Services, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2925 S Main St, Winston Salem, NC 27127-4006 | 2007-07-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306455126 | A Place 4 Me, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5305 Clearwater Lake Rd, Mount Holly, NC 28120-1445 | 2020-07-28 |
| 1922623792 | Our Home At Home LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4601 Waterford Knoll Dr Apt 1724, Charlotte, NC 28226-6015 | 2020-06-08 |
| 1922634484 | Tracey Holton | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Easterseals Ucp, 913 Carolina Ave N, Statesville, NC 28677 | 2020-03-17 |
| 1710443395 | Unity 4 Us Community Outreach | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 406 Lincoln St, Belmont, NC 28012-3045 | 2019-02-19 |
| 1871059444 | Believing Everyone Succeeds Together | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 323 Shady Grove Rd, Kings Mtn, NC 28086-9671 | 2019-02-19 |
| 1740744283 | Tri Plex Industries Corp | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 9635 Southern Pine Blvd Ste 154, Charlotte, NC 28273-5564 | 2019-01-29 |
| 1316415037 | Igr Collaborations | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 212 Pine Ridge Dr, Roanoke Rapids, NC 27870-6832 | 2018-11-12 |
| 1164924940 | David Douglas Whitfield | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5342 Us Highway 301 North, Micro, NC 27555 | 2018-03-07 |
| 1710489976 | Moravian Enterprises, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 122 North Elm St., Suite 810, Greensboro, NC 27401 | 2018-03-05 |
| 1659897833 | Shelby Day Program | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 621 S Dekalb St Ste A, Shelby, NC 28150-6189 | 2017-08-18 |
| Find all providers with the same taxonomy | ||||
| City | WINSTON SALEM |
| Zip Code | 27105 |
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| 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.