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WP-WINSTON-SALEM HEALTH HOLDINGS LLC NPI 1699011361


NPI Information

NPI: 1699011361
Provider Name: WP-WINSTON-SALEM HEALTH HOLDINGS, LLC

Doing Business As: MAGNOLIA CREEK ASSISTED LIVING

Classification: Custodial Care Facility - 311ZA0620X
Entity Type: Organization

Specialization: Adult Care Home

CLIA Number: 34D2019462

Address:
2560 WILLARD RD
WINSTON SALEM, NC
ZIP 27107
Phone: (336) 650-0699
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WP-WINSTON-SALEM HEALTH HOLDINGS, LLC is an adult care home custodial care facility in Winston Salem, NC. The provider is a custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. WP-WINSTON-SALEM HEALTH HOLDINGS, LLC NPI is 1699011361. The provider is registered as an organization entity type.
The provider Is Doing Business As Magnolia Creek Assisted Living.

The provider's business location address is:

2560 WILLARD RD
WINSTON SALEM, NC
ZIP 27107-543
Phone: (336) 650-0699
Fax: (336) 650-0132

The provider's authorized official is Charles E Trefzger .
The authorized official title is Manager and has the following contact phone number (828) 322-5535.

The CLIA number assigned to this NPI record is 34D2019462 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/27/2012 and was last updated on 10/26/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1310400000XAssisted Living FacilityHAL-034-097NORTH CAROLINANo
2343900000XNon-emergency Medical Transport (VAN)No
3311ZA0620XCustodial Care FacilityAdult Care HomeYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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