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MODA HUMAN SERVICES L.L.C
NPI 1013158039
Community Based Residential Treatment Facility, Mental Illness in Winston Salem, NC

Active since March 20, 2009
4420 EDREM AVE, WINSTON SALEM, NC 27101(336) 725-9395(336) 724-9365 Get Directions Write a Review

NPPES record last updated: March 20, 2009. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Moda Human Services L.l.c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MODA HUMAN SERVICES L.L.C (NPI 1013158039) is a healthcare organization registered as a community based residential treatment facility, mental illness in Winston Salem, North Carolina and active in the NPI registry since March 2009. The organization lists Malebogo Nanzala Samuzala, Owner, as its authorized official.

NPPES Registry Identity

NPI1013158039
Entity TypeOrganization
Primary Taxonomy320800000X
Legal Business NameMODA HUMAN SERVICES L.L.C
Location Address4420 EDREM AVEWinston Salem, NC 27101-2108
Mailing AddressPo Box 1073Winston Salem, NC 27102-1073 · (336) 725-9395 · Fax (336) 724-9365
Phone(336) 725-9395
Fax(336) 724-9365
Organization SubpartNo
Authorized OfficialMalebogo Nanzala SamuzalaOwner · (336) 705-0643
Enumeration DateMarch 20, 2009
✔ NPI 1013158039 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity Based Residential Treatment Facility, Mental IllnessResidential Treatment Facilities
Taxonomy Code320800000X
Definition
A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.
4420 EDREM AVE, Winston Salem, NC 27101
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Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NOA HUMAN SERVICES LLC
Clinic/Center (Mental Health (Including Community Mental Health Center))
4420 EDREM AVE
WINSTON SALEM, NC 27101
Forsyth County (336) 602-2534

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Moda Human Services L.L.C's NPI number?

The NPI number for Moda Human Services L.L.C is 1013158039. It was assigned to this organization in the NPPES registry on March 20, 2009.

Where is Moda Human Services L.L.C located?

Moda Human Services L.L.C is located at 4420 Edrem Ave, Winston Salem, NC 27101. The listed phone number is (336) 725-9395.

What is Moda Human Services L.L.C's specialty?

The primary specialty registered for this NPI is Community Based Residential Treatment Facility, Mental Illness with taxonomy code 320800000X.

When was this NPI record last updated?

The NPPES record for Moda Human Services L.L.C was last updated on March 20, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.