Healthcare Provider Details

I. General information

NPI: 1871403485
Provider Name (Legal Business Name): WINGS OF HOPE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3804 GRASSY CREEK DR
LEXINGTON KY
40503-4236
US

IV. Provider business mailing address

3804 GRASSY CREEK DR
LEXINGTON KY
40503-4236
US

V. Phone/Fax

Practice location:
  • Phone: 859-619-8801
  • Fax:
Mailing address:
  • Phone: 859-619-8801
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL LOWE
Title or Position: CEO
Credential: LCADC
Phone: 859-619-8801