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WOLFE & JACKSON GROUP HOME, INC
NPI 1790016517
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Winston Salem, NC

Active since January 18, 2010CLIA Certified · 2 labs
744 E SPRAGUE ST, WINSTON SALEM, NC 27107(336) 788-3004(336) 529-6454 Get Directions Write a Review

NPPES record last updated: March 8, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 8, 2024, Jul 5, 2023 (2 updates tracked since 2023).

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 1790016517) 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 January 2010. The organization holds 2 active CLIA laboratory certificates and lists Zelma Jackson Wolfe, Administrator, Ceo, as its authorized official.

NPPES Registry Identity

NPI1790016517
Entity TypeOrganization
Primary Taxonomy320900000X
Legal Business NameWOLFE & JACKSON GROUP HOME, INC
Location Address744 E SPRAGUE STWinston Salem, NC 27107-3246
Mailing AddressPo Box 12002Winston Salem, NC 27117-2002 · (336) 722-8354 · Fax (336) 722-8354
Phone(336) 788-3004
Fax(336) 529-6454
Organization SubpartNo
Authorized OfficialZelma Jackson WolfeAdministrator, Ceo · (336) 788-3004
Enumeration DateJanuary 18, 2010
Last NPPES UpdateMarch 8, 20242 updates tracked since enumeration
NPPES CertifiedMarch 8, 2024
✔ NPI 1790016517 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyCommunity Based Residential Treatment Facility, Intellectual and/or Developmental DisabilitiesResidential Treatment Facilities
Taxonomy Code320900000X
License✔ Licensed in NC · MHL-034-276
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities.
Also ListedCommunity/Behavioral HealthTaxonomy 251S00000X
Also ListedIn Home Supportive CareTaxonomy 253Z00000X
Also ListedRespite CareTaxonomy 385H00000X · License MHL-034-276 (NC)
744 E SPRAGUE ST, Winston Salem, NC 27107
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CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 34D2048616

Wolfe & Jackson Group Home · Winston Salem, NC
Active · expires Oct 18, 2026
CLIA Number34D2048616
Laboratory TypeGroup Home
Certificate Effective DateOctober 19, 2024
Certificate Expiration DateOctober 18, 2026
Laboratory DirectorZelma Wolfe
Laboratory Phone(336) 722-8354
Laboratory LocationWolfe & Jackson Group Home744 East Sprague Street, Winston Salem, NC 27107
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 34D2048625

Wolfe & Jackson Group Home #1 · Winston Salem, NC
Active · expires Oct 18, 2026
CLIA Number34D2048625
Laboratory TypeGroup Home
Certificate Effective DateOctober 19, 2024
Certificate Expiration DateOctober 18, 2026
Laboratory DirectorZelma Wolfe
Laboratory Phone(336) 722-8354
Laboratory LocationWolfe & Jackson Group Home #13913 Indiana Ave, Winston Salem, NC 27105
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 1790016517. It was assigned to this organization in the NPPES registry on January 18, 2010.

Where is Wolfe & Jackson Group Home, Inc located?

Wolfe & Jackson Group Home, Inc is located at 744 E Sprague St, Winston Salem, NC 27107. The listed phone number is (336) 788-3004.

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.

Does Wolfe & Jackson Group Home, Inc hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Wolfe & Jackson Group Home, Inc was last updated on March 8, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.