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BLUE STATE WELLNESS AND RECOVERY NPI 1487111787


NPI Information

NPI: 1487111787
Provider Name: BLUE STATE WELLNESS AND RECOVERY
Classification: Case Manager/Care Coordinator - 171M00000X
Entity Type: Organization
Address:
1930 LEGACY PARK
WINSTON SALEM, NC
ZIP 27103
Phone: (336) 287-1395
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BLUE STATE WELLNESS AND RECOVERY is a case manager care coordinator in Winston Salem, NC. The provider is a person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee's progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. BLUE STATE WELLNESS AND RECOVERY NPI is 1487111787. The provider is registered as an organization entity type.

The provider's business location address is:

1930 LEGACY PARK
WINSTON SALEM, NC
ZIP 27103-838
Phone: (336) 287-1395

The provider's authorized official is Brandon Williams .
The authorized official title is Chairman/member Manager and has the following contact phone number (336) 287-1395.

The enumeration date for this NPI number is 2/23/2019 and was last updated on 2/23/2019.


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
1174200000XMealsNo
2177F00000XLodgingNo
3251B00000XCase ManagementNo
4251C00000XDay Training, Developmentally Disabled ServicesNo
5251E00000XHome HealthNo
6251K00000XPublic Health or WelfareNo
7251S00000XCommunity/Behavioral HealthNo
8252Y00000XEarly Intervention Provider AgencyNo
9253Z00000XIn Home Supportive CareNo
10261QA0600XClinic/CenterAdult Day CareNo
11261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)No
12315P00000XIntermediate Care Facility, Intellectual DisabilitiesNo
13320600000XResidential Treatment Facility, Intellectual and/or Developmental DisabilitiesNo
14385HR2060XRespite CareRespite Care, Intellectual and/or Developmental DisabilitiesNo
15171M00000XCase Manager/Care CoordinatorYes

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.