Provider Demographics
NPI:1699821595
Name:WINSONG, INC
Entity Type:Organization
Organization Name:WINSONG, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:WINIFRED
Authorized Official - Middle Name:
Authorized Official - Last Name:CHOCKLETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-443-4154
Mailing Address - Street 1:PO BOX 1061
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27802-1061
Mailing Address - Country:US
Mailing Address - Phone:252-443-4154
Mailing Address - Fax:
Practice Address - Street 1:115 WYE ST
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27801-5679
Practice Address - Country:US
Practice Address - Phone:252-446-4440
Practice Address - Fax:252-443-4027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2008-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL033045320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness