C&W Alternative Family Living Facility, Inc.

Primary specialty

Mental Illness Intermediate Care FacilityTaxonomy code 310500000X

License

MHL- 034-160 Issued in NC

Legal business name

C&W ALTERNATIVE FAMILY LIVING FACILITY, INC.

Practice address

3365 New Walkertown Rd
Winston Salem, NC 27105-4160

Phone

(336) 723-3829

Fax

(336) 723-3829

NPI assigned

Mar 29, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Marshall Elmore, MS., QP.

Title

Administrator

Phone

(336) 723-3829

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1528188232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3365 NEW WALKERTOWN RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271054160",
            "telephone_number": "336-723-3829",
            "fax_number": "336-723-3829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3365 NEW WALKERTOWN RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271054160",
            "telephone_number": "336-723-3829",
            "fax_number": "336-723-3829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "C&W ALTERNATIVE FAMILY LIVING FACILITY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ELMORE",
        "authorized_official_first_name": "MARSHALL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "336-723-3829",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MS., QP."
    },
    "taxonomies": [
        {
            "code": "310500000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Mental Illness",
            "state": "NC",
            "license": "MHL- 034-160",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301339",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Graham Vance Byrum III, MD
• Peggy A Byun, MD
• C & Y Medical Service PA
• C.R.T. Golden Lamb Rest Home, Inc.
• C&G Group Home, LLC
• Elimarie Caballero Quinones
• Shana-Ann Caballes, CRNA
• Cabarrus Rowan Community Health Centers, Inc. (APHS-SHA at North Forsyth High School Student Center)
• Cabarrus Rowan Community Health Centers, Inc. (APHS-SHA at Old Town Elementary Student Health Center)
• Cabarrus Rowan Community Health Centers, Inc. (APHS-SHA at Mineral Springs Student Health Center)

• Mental Illness Intermediate Care Facility in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Mental Illness Intermediate Care Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.