| It Takes A Village Residential Care Llc | |
|
5008 Butterfield Dr Winston Salem NC 27105-3344 | |
| (336) 608-2819 | |
| Not Available |
| Full Name | It Takes A Village Residential Care Llc |
|---|---|
| Speciality | Residential Treatment Facility, Intellectual And/or Developmental Disabilities |
| Location | 5008 Butterfield Dr, Winston Salem, North Carolina |
| Authorized Official Name and Position | Chaquille Jackson (CEO) |
| Authorized Official Contact | 3366082819 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| It Takes A Village Residential Care Llc 5008 Butterfield Dr Winston Salem NC 27105-3344 Ph: (336) 608-2819 | It Takes A Village Residential Care Llc 5008 Butterfield Dr Winston Salem NC 27105-3344 Ph: (336) 608-2819 |
| NPI Number | 1407489529 |
|---|---|
| Provider Enumeration Date | 02/17/2020 |
| Last Update Date | 02/17/2020 |
| Certification Date | 02/17/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407489529 | NPI | - | NPPES |
| NA | Medicaid | NC |
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