W&G Community Services, Inc.

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

License

MHL-004-034 Issued in NC

Legal business name

W&G COMMUNITY SERVICES, INC.

Practice address

7612 Hwy 52 South
Morven, NC 28119

Phone

(704) 851-9000

NPI assigned

May 21, 2012

Organization subpart

No

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

Authorized official

Name

Fannie Clyburn

Title

Ceo

Phone

(704) 851-9000

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1337558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456185600000",
    "number": "1053671396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 JOHNSON ST",
            "city": "WADESBORO",
            "state": "NC",
            "postal_code": "281708106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7612 HWY 52 SOUTH",
            "city": "MORVEN",
            "state": "NC",
            "postal_code": "28119",
            "telephone_number": "704-851-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "W&G COMMUNITY SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-21",
        "last_updated": "2016-02-23",
        "status": "A",
        "authorized_official_last_name": "CLYBURN",
        "authorized_official_first_name": "FANNIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "704-851-9000"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "MHL-004-034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Morven, NC
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2016; 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.