Healthcare Provider Details

I. General information

NPI: 1588579726
Provider Name (Legal Business Name): KASEEN HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4411 OLD RURAL HALL RD
WINSTON SALEM NC
27105-2832
US

IV. Provider business mailing address

1930 LEGACY PARK APT 204
WINSTON SALEM NC
27103-5839
US

V. Phone/Fax

Practice location:
  • Phone: 336-917-8561
  • Fax: 336-287-1395
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. BRANDON WILLIAMS
Title or Position: PRESIDENT
Credential:
Phone: 336-917-8561