| Wtb New Vision Inc. | |
|
102 W 3rd St Suite 502 Winston Salem NC 27101-3940 | |
| (336) 723-7707 | |
| (336) 723-7708 |
| Full Name | Wtb New Vision Inc. |
|---|---|
| Speciality | Residential Treatment Facility, Emotionally Disturbed Children |
| Location | 102 W 3rd St, Winston Salem, North Carolina |
| Authorized Official Name and Position | Brian Hairston (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3367237707 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wtb New Vision Inc. 102 W 3rd St Suite 502 Winston Salem NC 27101-3987 Ph: (336) 723-7707 | Wtb New Vision Inc. 102 W 3rd St Suite 502 Winston Salem NC 27101-3940 Ph: (336) 723-7707 |
| NPI Number | 1982783049 |
|---|---|
| Provider Enumeration Date | 11/02/2006 |
| Last Update Date | 06/06/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982783049 | NPI | - | NPPES |
| 6603924 | Medicaid | NC | |
| 8300791 | Medicaid | NC | |
| 8300791B | Medicaid | NC | |
| 6603536 | Medicaid | NC | |
| 6604170 | Medicaid | NC | |
| 8300791G | Medicaid | NC |
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