Wescare Professional Services, LLC.
Organization Active NPI Mental Illness Community Based Residential Treatment Facility · Winston Salem, NC
NPI 1679975353 · NPPES record last updated Jul 3, 2018
Key facts
- NPI
- 1679975353
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mental Illness Community Based Residential Treatment Facility 320800000X
- License
- MHL-034-329 (NC)
- Legal business name
- WESCARE PROFESSIONAL SERVICES, LLC.
- Practice address
- 236 McTavish LN
Winston Salem, NC 27103 - Phone
- (336) 448-5676
- Fax
- (336) 272-8339
- NPI assigned
- Sep 24, 2014
- Organization subpart
- No
Authorized official
- Name
- Mr. Eric Michael Page
- Title
- Operations Manager
- Phone
- (336) 272-8335
Corporate family (same tax ID) 18
National Provider Directory
- Tax ID family
- Wescare Professional Services LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | MHL-034-329 | NC | |
| Intellectual and/or Developmental Disabilities Residential Treatment Facility | 320600000X | |||
| Mental Illness Community Based Residential Treatment Facility | 320800000X | MHL-034-329 | NC | Yes |
Addresses
Primary practice location
236 McTavish LN
Winston Salem, NC 27103
Mailing address
10 Oak Branch Dr Ste a
Greensboro, NC 27407-2995
Phone (336) 272-8335
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MHL-034-329 | Other | NC | LICENSE |
| 3418297 | Medicaid | NC |
Other names
- McTavish Home
Other providers in Winston Salem, NC
- Amanda Rose Wentz
- Donald J Wenzel
- Hope Werenski
- Madison Werley
- Wescare Professional Services, LLC.
- West First Street Operating Company, LLC
- Abbie Demarris West
- Alayna Lee West
- Gina West
- Joseph Benjamin West
All providers in Winston Salem, NC · Mental Illness Community Based Residential Treatment Facility in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 3, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.