Provider Demographics
NPI:1932232568
Name:THE CHILDRENS HOME INC
Entity Type:Organization
Organization Name:THE CHILDRENS HOME INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL MANAGER FAMILY COUNSELOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RONNIE
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:WILKES
Authorized Official - Suffix:JR
Authorized Official - Credentials:MSRC
Authorized Official - Phone:336-721-7638
Mailing Address - Street 1:1001 REYNOLDA RD
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27104-3245
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1001 REYNOLDA RD
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27104-3245
Practice Address - Country:US
Practice Address - Phone:336-721-7638
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children