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Wolfe & Jackson Group Home, Inc.
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Winston Salem, North Carolina
NPI 1265758916

Wolfe & Jackson Group Home, Inc. is a Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility based in Winston Salem, NC. Wolfe & Jackson Group Home, Inc. practices in Winston Salem, NC. The NPI Number for Wolfe & Jackson Group Home, Inc. is 1265758916 and holds a License No. (North Carolina).

The current practice location address for Wolfe & Jackson Group Home, Inc. is 3913 Indiana Ave, Winston Salem, NC and can be reached out via phone at 336-661-0923 and via fax at 336-793-1496. You can also correspond with Wolfe & Jackson Group Home, Inc. through the mailing address at PO BOX 4912, WINSTON SALEM, NC - 27115-4912 (mailing address contact number: 336-245-0303).

Location: 3913 Indiana Ave, Winston Salem, NC, 27115-4912
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1265758916
Provider Name
Wolfe & Jackson Group Home, Inc.
Credential
Provider Entity Type
Organization
Address
3913 Indiana Ave, Winston Salem, NC, 27115-4912
Phone Number
336-661-0923
Fax Number
336-793-1496
Provider Enumeration Date
04/20/2010
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
3419271 05 NC
institution
Provider Business Practice Location Address Details
Address
3913 Indiana Ave
City
Winston Salem
State
North Carolina
Zip
27105-3410
Phone Number
336-661-0923
Fax Number
336-793-1496
person
Provider Business Mailing Address Details
Address
3913 Indiana Ave
City
Winston Salem
State
North Carolina
Zip
27105-3410
Phone Number
336-661-0923
Fax Number
336-793-1496
person
Provider's Taxonomy Details 1
Type
Agencies
Classification
In Home Supportive Care
Speciality
-
Taxonomy
253Z00000X
License No.
MHL 034-254 (North Carolina)
Definition
An In Home Supportive Care Agency provides services in the patient's home with the goal of enabling the patient to remain at home. The services provided may include personal care services such as hands-on assistance with activities of daily living (ADLs), e.g., eating, bathing, dressing, and bladder and bowel requirements; homemaker services and instrumental activities of daily living (IADLs), e.g., taking medications, shopping for groceries, laundry, housekeeping, and companionship; and/or supervision or cuing so that a person can perform tasks themselves.
person
Provider's Taxonomy Details 2
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320900000X
License No.
()
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
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