| Wagner & Wilson Enterprises, Llc | |
|
1911 Willimax Ave Gastonia NC 28054-7440 | |
| (704) 771-0985 | |
| Not Available |
| Full Name | Wagner & Wilson Enterprises, Llc |
|---|---|
| Speciality | Community Based Residential Treatment Facility, Mental Illness |
| Location | 1911 Willimax Ave, Gastonia, North Carolina |
| Authorized Official Name and Position | Cherie' Wagner (CO- OWNER/EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7047710985 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wagner & Wilson Enterprises, Llc 938 Glencoe St Winston Salem NC 27107-3315 Ph: (704) 771-0985 | Wagner & Wilson Enterprises, Llc 1911 Willimax Ave Gastonia NC 28054-7440 Ph: (704) 771-0985 |
| NPI Number | 1851133326 |
|---|---|
| Provider Enumeration Date | 06/06/2024 |
| Last Update Date | 06/13/2024 |
| Certification Date | 06/13/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851133326 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 320800000X | Community Based Residential Treatment Facility, Mental Illness | (* (Not Available)) | Primary |
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