Provider Demographics
NPI:1225129737
Name:V.I.P CARE SERVICES, INC.
Entity Type:Organization
Organization Name:V.I.P CARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-896-0680
Mailing Address - Street 1:3640 WESTGATE CENTER CIR
Mailing Address - Street 2:SUITE B
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-3056
Mailing Address - Country:US
Mailing Address - Phone:336-896-0680
Mailing Address - Fax:336-896-0614
Practice Address - Street 1:3640 WESTGATE CENTER CIR
Practice Address - Street 2:SUITE B
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-3056
Practice Address - Country:US
Practice Address - Phone:336-896-0680
Practice Address - Fax:336-896-0614
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2010-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8301752Medicaid
NC3418162Medicaid