Provider Demographics
NPI:1528733524
Name:H&W ENTERPRISES OF NC LLC
Entity type:Organization
Organization Name:H&W ENTERPRISES OF NC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATIONS OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-721-4262
Mailing Address - Street 1:301 N MAIN ST STE 1202
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27101-3819
Mailing Address - Country:US
Mailing Address - Phone:336-721-4262
Mailing Address - Fax:336-232-1630
Practice Address - Street 1:130 TIBET AV
Practice Address - Street 2:UNIT 202
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406
Practice Address - Country:US
Practice Address - Phone:912-335-1743
Practice Address - Fax:866-223-4332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-11
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA251S00000XMedicaid