| Organization Name: | WESCARE PROFESSIONAL SERVICES, LLC. |
| NPI Number: | 1679975353 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ERIC M. PAGE (OPERATIONS MANAGER) |
| Mailing Address: | 4392 Monica Ct Winston Salem |
| State: | NC US |
| Postal Code: | 271077707 |
| Phone Number: | 3364485676 |
| Fax Number: | 3362728339 |
| NPI Enumeration Date: | 09/24/2014 |
| NPI Last Update Date: | 08/03/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 320600000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Residential Treatment Facilities |
| Taxonomy Classification: | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |