Provider Demographics
NPI:1972650612
Name:WNC MADISON COUNTY HOUSING CORP
Entity Type:Organization
Organization Name:WNC MADISON COUNTY HOUSING CORP
Other - Org Name:MADISON COUNTY GROUP HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:WRENN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-622-3332
Mailing Address - Street 1:PO BOX 97
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:28743-0097
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:36 MOUNTAIN HEIGHTS AVE
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:NC
Practice Address - Zip Code:28743
Practice Address - Country:US
Practice Address - Phone:828-622-3332
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2011-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL057014251C00000X
320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3409126Medicaid
NC7803510Medicaid