MEDICARE: WE CARE VA, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1790192763
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WE CARE VA, LLC

Provider Business Mailing Address
First Line	:	403 MOUNT CROSS RD
Second Line	:	SUITE 102
City	:	DANVILLE
State	:	VA
Zip	:	24540-5561
Country	:	US
Telephone Number	:	336-926-4484
Fax Number	:

Provider Business Practice Location Address
First Line	:	2673 NINFIELD DR
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27103-6989
Country	:	US
Telephone Number	:	336-926-4484
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MRS. JENNIFER KING
Credential	:
Telephone Number	:	336-926-4484

Provider Enumeration Date	:	07/22/2014
Last Update Date	:	07/22/2014

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Directions to “WE CARE VA, LLC ” Practice Location

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