Winston Salem Holdings LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

HAL034079 Issued in NC

Legal business name

WINSTON SALEM HOLDINGS LLC

Doing business as

Reynolds House

Practice address

2900 Reynolds Park Rd
Winston Salem, NC 27107-1653

Phone

(336) 785-0050

Fax

(336) 784-6187

NPI assigned

Feb 23, 2007

Last updated

Jun 24, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kenneth Hodges

Title

Member Manager

Phone

(828) 738-3046

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Reynolds House Doing business as

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214265600000",
    "number": "1144356379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 REYNOLDS PARK RD",
            "address_2": "PO BOX 12937",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271071653",
            "telephone_number": "336-785-0050",
            "fax_number": "336-784-6187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 REYNOLDS PARK RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271071653",
            "telephone_number": "336-785-0050",
            "fax_number": "336-784-6187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINSTON SALEM HOLDINGS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-23",
        "last_updated": "2008-06-24",
        "status": "A",
        "authorized_official_last_name": "HODGES",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "MEMBER MANAGER",
        "authorized_official_telephone_number": "828-738-3046"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NC",
            "license": "HAL034079",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7805586",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Reynolds House",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Winston Salem Dermatology & Surgery
• Winston Salem Healthcare LLC (Grace Healthcare of Winston Salem)
• Winston Salem Industries for the Blind
• Winston Salem Optometric Group PA (C distinctive eyewear)
• Winston Salem Rehab Operations LLC
• Winston Salem State University (WSSU Wellness Center Pharmacy)
• Winston Salem State University, a. H. Ray Student Health Service

• Assisted Living Facility in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Assisted Living Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 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.