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General NPI Number Information
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NPI Number | 1760982888
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Entity Type | Organization
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Legal Business Name | WESCARE PROFESSIONAL SERVICES, LLC.
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Dates
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Enumeration Date | 02/15/2018
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Last Update Date | 06/11/2018
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Provider Practice Location Address
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Address Line | 300 BINGHAM ST
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City | GREENSBORO
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State | NC
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Zip | 27401
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Country | US
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Telephone | 336-285-5663
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Fax |
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Provider Business Mailing Address
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Address Line | 3709 PETERFORD DR
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City | GREENSBORO
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State | NC
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Zip | 27405-9311
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MR. DANIEL PATRICK HOLDING
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Credential |
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Telephone | 336-587-6924
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number | MHL-041-1159
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License Number State | NC
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