Provider Demographics
NPI:1326406729
Name:IWIN, LLC
Entity Type:Organization
Organization Name:IWIN, LLC
Other - Org Name:BONNY VALENTINE
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:BONNY
Authorized Official - Middle Name:
Authorized Official - Last Name:VALENTINE
Authorized Official - Suffix:
Authorized Official - Credentials:CPC,MLC
Authorized Official - Phone:704-245-6409
Mailing Address - Street 1:909 S MAIN ST
Mailing Address - Street 2:SUITE 206
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28144-6416
Mailing Address - Country:US
Mailing Address - Phone:704-754-6690
Mailing Address - Fax:
Practice Address - Street 1:909 S MAIN ST
Practice Address - Street 2:SUITE 206
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144-6416
Practice Address - Country:US
Practice Address - Phone:704-754-6690
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-01
Last Update Date:2016-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled Services