Wolfe & Jackson Family Care Home

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

WOLFE & JACKSON FAMILY CARE HOME

Practice address

3913 Indiana Ave
Winston Salem, NC 27105-3410

Phone

(336) 661-9032

NPI assigned

Jul 14, 2008

Organization subpart

Yes

Parent organization

WOLFE & JACKSON FAMILY CARE HOMEAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Zelma Jackson Wolfe

Title

Administrator

Phone

(336) 722-8354

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• w & j adult services Other name

Tax ID family

Wolfe Jackson Family Care Home2 organizations share this tax ID, including this one

Part of

Wolfe Jackson Family Care Home

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Wolfe & Jackson Family Care Home

  • Adult Care Home Facility
  • Winston Salem, NC
  • NPI 1457476913
  NPD tax ID

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Wolfe & Jackson Family Care Home

  • Adult Care Home Facility
  • Winston Salem, NC
  • NPI 1457476913
  NPPES parent name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1215993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215993600000",
    "number": "1023272663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12002",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271172002",
            "telephone_number": "336-722-8354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3913 INDIANA AVE",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271053410",
            "telephone_number": "336-661-9032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOLFE & JACKSON FAMILY CARE HOME",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WOLFE & JACKSON FAMILY CARE HOME",
        "enumeration_date": "2008-07-14",
        "last_updated": "2008-07-14",
        "status": "A",
        "authorized_official_last_name": "WOLFE",
        "authorized_official_first_name": "ZELMA",
        "authorized_official_middle_name": "JACKSON",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "336-722-8354",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7802068",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "w & j adult services",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jobira Anbessie Woldemichael, MD
• Cara Elizabeth Harrity Wolf, CNM
• Karen Michelle Wolf
• Patricia Ann Wolf, BT
• Ryan Michael Wolf, M.D.
• Wolfe & Jackson Family Care Home
• Wolfe & Jackson Group Home, Inc
• Wolfe & Jackson Group Home, Inc.
• April B. Wolfe, OTR/L
• Emily Wolfe, MSW, LCSW-A

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.