Derek'S Place 2
Home Health in Winston Salem, NC. Organization (NPI-2).
NPI number1043978331
StatusActive
Last updated in NPPESFeb 23, 2022
Details
- NPI
- 1043978331
- Entity type
- Organization (NPI-2)
- Legal business name
- Derek'S Place 2
- Organization subpart
- No
- Enumeration date
- Dec 3, 2021
- Certification date
- Feb 23, 2022
- Last updated
- Feb 23, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 251E00000X | Home Health | – | – | Yes |
| 253Z00000X | In Home Supportive Care | – | – | |
| 343900000X | Non-emergency Medical Transport (VAN) | – | – | |
| 251C00000X | Day Training, Developmentally Disabled Services | – | – | |
| 251J00000X | Nursing Care | – | – | |
| 251S00000X | Community/Behavioral Health | – | – |
Practice location
8025 N Point Blvd Ste 265Winston Salem, NC 27106-3859
Phone 336-575-4463
Mailing address
1504 Ne 21st StWinston Salem, NC 27105-6208
Authorized official
Eric Hairston
Administrator
3367264309
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