Healthcare Provider Details

I. General information

NPI: 1912902230
Provider Name (Legal Business Name): LUTHERAN HOME-WINSTON-SALEM, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2005
Last Update Date: 02/04/2026
Certification Date: 02/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

849 WATERWORKS RD
WINSTON SALEM NC
27101-1956
US

IV. Provider business mailing address

5350 OLD WALKERTOWN RD
WINSTON-SALEM NC
27105-2060
US

V. Phone/Fax

Practice location:
  • Phone: 336-595-2166
  • Fax: 336-595-2169
Mailing address:
  • Phone: 336-595-2166
  • Fax: 336-595-2169

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberNH0058
License Number StateNC

VIII. Authorized Official

Name: TED GOINS
Title or Position: PRESIDENT
Credential:
Phone: 704-637-2870