Provider Demographics
NPI:1992985790
Name:WENDY'S HOUSE, INC.
Entity type:Organization
Organization Name:WENDY'S HOUSE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:GWENDILYN
Authorized Official - Middle Name:D
Authorized Official - Last Name:LINCICOME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-338-2932
Mailing Address - Street 1:606 GATTIS ST
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27701-2832
Mailing Address - Country:US
Mailing Address - Phone:919-338-2932
Mailing Address - Fax:919-338-2962
Practice Address - Street 1:606 GATTIS ST
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27701-2832
Practice Address - Country:US
Practice Address - Phone:919-338-2932
Practice Address - Fax:919-338-2962
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-08
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services