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WTB NEW VISION INC. NPI 1982783049


NPI Information

NPI: 1982783049
Provider Name: WTB NEW VISION INC.
Classification: Residential Treatment Facility, Emotionally Disturbed Children - 322D00000X
Entity Type: Organization
Address:
102 W 3RD ST
SUITE 502
WINSTON SALEM, NC
ZIP 27101
Phone: (336) 723-7707
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WTB NEW VISION INC. is a residential treatment facility emotionally disturbed children in Winston Salem, NC. The provider is a residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently. WTB NEW VISION INC. NPI is 1982783049. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

102 W 3RD ST
SUITE 502
WINSTON SALEM, NC
ZIP 27101-940
Phone: (336) 723-7707
Fax: (336) 723-7708

The provider's authorized official is Brian Hairston .
The authorized official title is Executive Director and has the following contact phone number (336) 723-7707.

The enumeration date for this NPI number is 11/2/2006 and was last updated on 6/6/2014.


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
1101YM0800XCounselorMental HealthNo
2322D00000XResidential Treatment Facility, Emotionally Disturbed ChildrenMHL-034-185NORTH CAROLINANo
3322D00000XResidential Treatment Facility, Emotionally Disturbed ChildrenMHL-034-170NORTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
16604170MEDICAIDNORTH CAROLINA
28300791GMEDICAIDNORTH CAROLINA
38300791MEDICAIDNORTH CAROLINA
48300791BMEDICAIDNORTH CAROLINA
56603536MEDICAIDNORTH CAROLINA
66603924MEDICAIDNORTH CAROLINA

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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