Provider Demographics
NPI:1255423398
Name:COMMUNITY CARE OF WESTERN NORTH CAROLINA, INC.
Entity type:Organization
Organization Name:COMMUNITY CARE OF WESTERN NORTH CAROLINA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:WEHE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-348-2818
Mailing Address - Street 1:53 S FRENCH BROAD AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-3272
Mailing Address - Country:US
Mailing Address - Phone:828-259-3879
Mailing Address - Fax:828-259-3875
Practice Address - Street 1:53 S FRENCH BROAD AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-3272
Practice Address - Country:US
Practice Address - Phone:828-259-3879
Practice Address - Fax:828-259-3875
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6701007Medicaid
NC3408363Medicaid