Provider Demographics
NPI:1427365865
Name:WILKES COUNTY ADULT CARE, INC
Entity Type:Organization
Organization Name:WILKES COUNTY ADULT CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FRED
Authorized Official - Middle Name:H
Authorized Official - Last Name:LEONARD
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:828-659-3418
Mailing Address - Street 1:176 RESTHOME RD
Mailing Address - Street 2:
Mailing Address - City:WILKESBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28697-7145
Mailing Address - Country:US
Mailing Address - Phone:336-973-3890
Mailing Address - Fax:336-973-3042
Practice Address - Street 1:176 RESTHOME RD
Practice Address - Street 2:
Practice Address - City:WILKESBORO
Practice Address - State:NC
Practice Address - Zip Code:28697-7145
Practice Address - Country:US
Practice Address - Phone:336-973-3890
Practice Address - Fax:336-973-3042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-07
Last Update Date:2010-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHAL-097-013311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home