| Wesley Shelter, Inc | |
|
106 Vance St E Wilson NC 27893-4034 | |
| (252) 291-2344 | |
| (252) 291-1436 |
| Full Name | Wesley Shelter, Inc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 106 Vance St E, Wilson, North Carolina |
| Authorized Official Name and Position | Kim Gauss (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 2522912344 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wesley Shelter, Inc 106 East Vance Street Wilson NC 27894 Ph: (252) 291-2344 | Wesley Shelter, Inc 106 Vance St E Wilson NC 27893-4034 Ph: (252) 291-2344 |
| NPI Number | 1144294190 |
|---|---|
| Provider Enumeration Date | 02/15/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144294190 | NPI | - | NPPES |
| 6105081 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 2683 (North Carolina) | Primary |
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