| Northwest Community Care Network | |
|
1920 W 1st St Winston Salem NC 27104-4220 | |
| (336) 716-5654 | |
| (336) 716-2683 |
| Full Name | Northwest Community Care Network |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1920 W 1st St, Winston Salem, North Carolina |
| Authorized Official Name and Position | Jim Graham (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3367165654 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northwest Community Care Network Po Box 15046 Winston Salem NC 27113-0046 Ph: (336) 716-5654 | Northwest Community Care Network 1920 W 1st St Winston Salem NC 27104-4220 Ph: (336) 716-5654 |
| NPI Number | 1447392337 |
|---|---|
| Provider Enumeration Date | 02/14/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447392337 | NPI | - | NPPES |
| 6005897 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | C001547 (North Carolina) | Primary |
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