Wagner & Wilson Enterprises, Llc | |
1911 Willimax Ave Gastonia NC 28054-7440 | |
(704) 771-0985 | |
Not Available |
Full Name | Wagner & Wilson Enterprises, Llc |
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Speciality | Community Based Residential Treatment Facility, Mental Illness |
Location | 1911 Willimax Ave, Gastonia, North Carolina |
Authorized Official Name and Position | Cherie' Wagner (CO- OWNER/EXECUTIVE DIRECTOR) |
Authorized Official Contact | 7047710985 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Wagner & Wilson Enterprises, Llc 938 Glencoe St Winston Salem NC 27107-3315 Ph: (704) 771-0985 | Wagner & Wilson Enterprises, Llc 1911 Willimax Ave Gastonia NC 28054-7440 Ph: (704) 771-0985 |
NPI Number | 1851133326 |
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Provider Enumeration Date | 06/06/2024 |
Last Update Date | 06/13/2024 |
Certification Date | 06/13/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1851133326 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
320800000X | Community Based Residential Treatment Facility, Mental Illness | (* (Not Available)) | Primary |
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