Healthcare Provider Details

I. General information

NPI: 1629441571
Provider Name (Legal Business Name): W.I.N.G.S., LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2015
Last Update Date: 08/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6584 LANDOVER BLVD
SPRING HILL FL
34608-1313
US

IV. Provider business mailing address

6584 LANDOVER BLVD
SPRING HILL FL
34608-1313
US

V. Phone/Fax

Practice location:
  • Phone: 352-585-3351
  • Fax: 352-596-6141
Mailing address:
  • Phone: 352-585-3351
  • Fax: 352-596-6141

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateFL

VIII. Authorized Official

Name: DEBORAH LAMENDOLA
Title or Position: OWNER
Credential:
Phone: 352-585-3351