Provider Demographics
NPI:1972931780
Name:WILKES SENIOR RESOURCES, INC.
Entity type:Organization
Organization Name:WILKES SENIOR RESOURCES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY SERVICES DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-667-5926
Mailing Address - Street 1:228 FAIRPLAINS SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:N WILKESBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28659-3101
Mailing Address - Country:US
Mailing Address - Phone:336-667-5926
Mailing Address - Fax:336-667-8295
Practice Address - Street 1:228 FAIRPLAINS SCHOOL RD
Practice Address - Street 2:
Practice Address - City:N WILKESBORO
Practice Address - State:NC
Practice Address - Zip Code:28659-3101
Practice Address - Country:US
Practice Address - Phone:336-667-5926
Practice Address - Fax:336-667-8295
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-15
Last Update Date:2013-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC0544261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service