Active NPI
Wolfe & Jackson Family Care Home
- Adult Care Home Facility
- Winston Salem, NC
National Provider Identifier
1457476913
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Care Home Facility
- License
- FCL034020
- Legal business name
- WOLFE & JACKSON FAMILY CARE HOME
- Practice address
- 744 East Sprague Street
Winston Salem, NC 27107-3246 - Phone
- (336) 722-8354
- Fax
- (336) 722-8354
- NPI assigned
- Mar 20, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Zelma Jackson Wolfe
- Title
- Adminstator
- Phone
- (335) 722-8354
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Care Home Facility | 311ZA0620X | FCL034020 | NC | Primary |
Addresses
Primary practice location
744 East Sprague Street
Winston Salem, NC 27107-3246
Mailing address
PO Box 12002
Winston Salem, NC 27117-2002
Phone (336) 722-8354
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7802068 | Other | NC | PROVIDER # |
| 237701279P | Medicaid | NC |
National Provider Directory
National Provider Directory- Tax ID family
- 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.
-
- Intellectual and/or Developmental Disabilities Residential Treatment Facility
- Winston Salem, NC
- NPI 1023272663
Ownership & related parties
Subparts reporting this organization as parent 1
Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.
-
- Intellectual and/or Developmental Disabilities Residential Treatment Facility
- Winston Salem, NC
- NPI 1023272663
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174348800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1215734400000",
"number": "1457476913",
"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",
"fax_number": "336-722-8354"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "744 EAST SPRAGUE STREET",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271073246",
"telephone_number": "336-722-8354",
"fax_number": "336-722-8354"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WOLFE & JACKSON FAMILY CARE HOME",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-20",
"last_updated": "2008-07-11",
"status": "A",
"authorized_official_last_name": "WOLFE",
"authorized_official_first_name": "ZELMA",
"authorized_official_middle_name": "JACKSON",
"authorized_official_title_or_position": "ADMINSTATOR",
"authorized_official_telephone_number": "335-722-8354",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "311ZA0620X",
"taxonomy_group": "",
"desc": "Custodial Care Facility, Adult Care Home",
"state": "NC",
"license": "FCL034020",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PROVIDER #",
"identifier": "7802068",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "237701279P",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Winston Salem, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 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.