WESCARE PROFESSIONAL SERVICES, LLC. (NPI# 1679975353) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679975353 |
| Entity Type | Organization |
| Organization Name | WESCARE PROFESSIONAL SERVICES, LLC. |
| Other Organization Name | MCTAVISH HOME |
| Practice Address |
236 Mctavish Ln Winston Salem NC 27103 |
| Mailing Address |
10 Oak Branch Dr Ste A Greensboro NC 27407-2995 |
| Practice Telephone | 3364485676 |
| Practice Fax Number | 3362728339 |
| Mailing Telephone | 3362728335 |
| Mailing Fax Number | 3362728339 |
| Enumeration Date | 2014-09-24 |
| Last Update Date | 2018-07-03 |
| Authorized Official Name | MR. ERIC MICHAEL PAGE (OPERATIONS MANAGER) |
| Authorized Official Telephone | 3362728335 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251S00000X | Community/Behavioral Health | MHL-034-329 | NC | Agencies |
| N | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities | ||
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | MHL-034-329 | NC | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 3418297 | 05 | |
| NC | LICENSE | MHL-034-329 | 01 |
| Other Name | Type Code |
|---|---|
| McTavish Home | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639674765 | Wescare Professional Services, LLC. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1080 Walden Rd, Asheboro, NC 27205-1544 | 2018-03-29 |
| 1760982888 | Wescare Professional Services, LLC. | Community Based Residential Treatment Facility, Mental Illness | 300 Bingham St, Greensboro, NC 27401 | 2018-02-15 |
| 1306384391 | Wescare Professional Services, LLC. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 115 Boyd St, Eden, NC 27288-4630 | 2017-02-09 |
| 1902263106 | Wescare Professional Services, LLC. | Community/Behavioral Health | 5709 Cranberry Ct, Greensboro, NC 27405-9511 | 2016-01-20 |
| 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 |
| 1811373624 | Wescare Professional Services, LLC. | Community Based Residential Treatment Facility, Mental Illness | 5221 Fox Hunt Dr, B, Greensboro, NC 27407-7143 | 2015-08-04 |
| 1598141582 | Wescare Professional Services, LLC. | Community Based Residential Treatment Facility, Mental Illness | 318 E Vandalia Rd, Greensboro, NC 27406-5906 | 2015-08-03 |
| 1063898013 | Wescare Professional Services, LLC. | Community Based Residential Treatment Facility, Mental Illness | 4759 Eagle Path, Winston Salem, NC 27127-6816 | 2015-07-31 |
| 1356734669 | Wescare Professional Services, LLC. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 203 Wilson St, Graham, NC 27253-2721 | 2015-03-11 |
| 1407258189 | Wescare Professional Services, LLC. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2813 Lees Chapel Rd, Browns Summit, NC 27214-9615 | 2014-09-24 |
| Street Address |
236 MCTAVISH LN |
| City | WINSTON SALEM |
| State | NC |
| Zip Code | 27103 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124648126 | Kelly Anne Wales | Pharmacist | 3917-a Westpoint Boulevard, Winston-salem, NC 27103 | 2020-04-20 |
| 1386281533 | Elena Mcginty | Nurse Practitioner | 1225 Creekshire Way, Suite 270, Winston Salem, NC 27103 | 2019-12-06 |
| 1992359442 | Madeline Pryor | Pharmacist | 255 Charlois Drive, Winston Salem, NC 27103 | 2019-08-01 |
| 1215599584 | Palmetto Oxygen LLC | Durable Medical Equipment & Medical Supplies | 1100 S Stratford Road, Building B, Suite 420, Winston Salem, NC 27103 | 2019-07-07 |
| 1548734718 | Trivy Johnson | Specialist | 1384-b Westgate Center Dr., Winston Salem, NC 27103 | 2019-01-21 |
| 1447745047 | Novant Health Rehabilitation Hospital of Winston-salem, LLC | Rehabilitation Hospital | 2475 Hillcrest Center Circle, Winston Salem, NC 27103 | 2018-06-26 |
| 1346740206 | Joseph Miller | Physical Therapist | 1605 Westbrook Dr, Suite 103, Winston-salem, NC 27103 | 2018-02-17 |
| 1548779101 | Kristin Blow | Counselor | 3000 Bethesda Pl Ste 202, Winston Salem, NC 27103 | 2017-09-27 |
| 1891213443 | Alisha Dawn Wilson | Occupational Therapy Assistant | 2101 Homestead Hills Drive, Winston Salem, NC 27103 | 2017-09-05 |
| 1588186969 | Brandy Wilson | Social Worker | 153 Cameron Way Circle, Winston Salem, NC 27103 | 2017-07-07 |
| Find all providers in zip 27103 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154897239 | Elevated Family Services, LLC | Community Based Residential Treatment Facility, Mental Illness | 128 Laura Ave, Winston Salem, NC 27105-1319 | 2018-10-16 |
| 1063898013 | Wescare Professional Services, LLC. | Community Based Residential Treatment Facility, Mental Illness | 4759 Eagle Path, Winston Salem, NC 27127-6816 | 2015-07-31 |
| 1679708366 | Sharpe and Williams Family Care Home | Community Based Residential Treatment Facility, Mental Illness | 2740 New Walkertown Rd, Winston Salem, NC 27105-4818 | 2009-05-25 |
| 1013158039 | Moda Human Services L.l.c | Community Based Residential Treatment Facility, Mental Illness | 4420 Edrem Ave, Winston Salem, NC 27101-2108 | 2009-03-20 |
| 1346466539 | Transitions Group Facilities Incorporated | Community Based Residential Treatment Facility, Mental Illness | 989 Hutton St, Winston Salem, NC 27101-5715 | 2007-04-17 |
| 1275677916 | Family United Inc. | Community Based Residential Treatment Facility, Mental Illness | 117 Scotland Ridge Dr, Winston Salem, NC 27107-1877 | 2007-02-16 |
| 1730226770 | G&d Quality Care, Inc. | Community Based Residential Treatment Facility, Mental Illness | 3530 Renon Rd, Winston Salem, NC 27127-5036 | 2007-01-31 |
| 1003961418 | Hosanna House of Transition | Community Based Residential Treatment Facility, Mental Illness | 717 S Marshall St, Suite 100, Winston Salem, NC 27101-5808 | 2007-01-24 |
| 1588721591 | Grandfather Home Community Services for Children | Community Based Residential Treatment Facility, Mental Illness | 5560 Sturmer Park Cir, Winston Salem, NC 27105-1372 | 2007-01-02 |
| 1669542817 | Corbin House, Inc. | Community Based Residential Treatment Facility, Mental Illness | 400 Corbin St, Winston Salem, NC 27107-1960 | 2006-11-08 |
| Find all providers in WINSTON SALEM | ||||
| City | WINSTON SALEM |
| Zip Code | 27103 |
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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.