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WOLFE & JACKSON GROUP HOME, INC.
NPI 1265758916
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Winston Salem, NC

Active since April 20, 2010
3913 INDIANA AVE, WINSTON SALEM, NC 27105(336) 661-0923(336) 793-1496 Get Directions Write a Review

NPPES record last updated: July 25, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 25, 2023, Apr 29, 2017 (2 updates tracked since 2017).

About Wolfe & Jackson Group Home, Inc. NPPES

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

WOLFE & JACKSON GROUP HOME, INC. (NPI 1265758916) is a healthcare organization registered as a community based residential treatment facility, intellectual and/or developmental disabilities in Winston Salem, North Carolina and active in the NPI registry since April 2010. The organization lists Zelma Jackson- Wolfe, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1265758916
Entity TypeOrganization
Primary Taxonomy320900000X
Legal Business NameWOLFE & JACKSON GROUP HOME, INC.
Location Address3913 INDIANA AVEWinston Salem, NC 27105-3410
Mailing AddressPo Box 4912Winston Salem, NC 27115-4912 · (336) 245-0303 · Fax (336) 722-8354
Phone(336) 661-0923
Fax(336) 793-1496
Organization SubpartNo
Authorized OfficialZelma Jackson- WolfeExecutive Director · (336) 749-7660
Enumeration DateApril 20, 2010
Last NPPES UpdateJuly 25, 20232 updates tracked since enumeration
NPPES CertifiedJuly 25, 2023
✔ NPI 1265758916 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCommunity Based Residential Treatment Facility, Intellectual and/or Developmental DisabilitiesResidential Treatment Facilities
Taxonomy Code320900000X
License✔ Licensed in NC · MHL 034-254
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities.
Also ListedIn Home Supportive CareTaxonomy 253Z00000X
3913 INDIANA AVE, Winston Salem, NC 27105
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Other Identifiers 1

Medicaid3419271NC

Other Providers at the Same Location NPPES

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

WOLFE & JACKSON FAMILY CARE HOME
Residential Treatment Facility, Intellectual and/or Developmental Disabilities
3913 INDIANA AVE
WINSTON SALEM, NC 27105
Forsyth County (336) 661-9032

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 Wolfe & Jackson Group Home, Inc.'s NPI number?

The NPI number for Wolfe & Jackson Group Home, Inc. is 1265758916. It was assigned to this organization in the NPPES registry on April 20, 2010.

Where is Wolfe & Jackson Group Home, Inc. located?

Wolfe & Jackson Group Home, Inc. is located at 3913 Indiana Ave, Winston Salem, NC 27105. The listed phone number is (336) 661-0923.

What is Wolfe & Jackson Group Home, Inc.'s specialty?

The primary specialty registered for this NPI is Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320900000X.

When was this NPI record last updated?

The NPPES record for Wolfe & Jackson Group Home, Inc. was last updated on July 25, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.