NPIMap

Organization Active NPI

Wilson'S Constant Care, LLC

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Winston Salem, NC
National Provider Identifier
1821176702
Registry record updated Aug 23, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
License
MHL-034-201 Issued in NC
Legal business name
WILSON'S CONSTANT CARE, LLC
Practice address
1228 Highland Ave
Winston Salem, NC 27101-1625
Phone
(336) 703-9650
Fax
(336) 703-9793
NPI assigned
Nov 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2007

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

Authorized official

Name
Ms. Katherine Nabrena Wilson
Title
Ceo/Executive Director
Phone
(336) 391-3476

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Community/Behavioral Health Agency 251S00000X
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X MHL-034-201 NC Primary
Respite Care 385H00000X
Child Mental Illness Respite Care 385HR2055X
Child Intellectual and/or Developmental Disabilities Respite Care 385HR2060X

Addresses

Primary practice location

1228 Highland Ave
Winston Salem, NC 27101-1625

Mailing address

1228 Highland Ave
Winston Salem, NC 27101-1625
Phone (336) 703-9650

Other identifiers 1

IdentifierTypeStateIssuer
6604063MedicaidNC

Other names 1

  • Wilson's Constant Care Other name

National Provider Directory

National Provider Directory
Tax ID family
Wilson'S Constant Care3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187827200000",
    "number": "1821176702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1228 HIGHLAND AVE",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271011625",
            "telephone_number": "336-703-9650",
            "fax_number": "336-703-9793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1228 HIGHLAND AVE",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271011625",
            "telephone_number": "336-703-9650",
            "fax_number": "336-703-9793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILSON'S CONSTANT CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-08-23",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_middle_name": "NABRENA",
        "authorized_official_title_or_position": "CEO/EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "336-391-3476",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NC",
            "license": "MHL-034-201",
            "primary": true
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385HR2055X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Mental Illness, Child",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6604063",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wilson's Constant Care",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Aug 23, 2007; 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.