Healthcare Provider Details

I. General information

NPI: 1528267598
Provider Name (Legal Business Name): HOPE ON WINGS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2007
Last Update Date: 07/11/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

56 W VINEYARD LN
HAYESVILLE NC
28904-5603
US

IV. Provider business mailing address

56 W VINEYARD LN
HAYESVILLE NC
28904-5603
US

V. Phone/Fax

Practice location:
  • Phone: 828-389-8350
  • Fax: 828-389-9064
Mailing address:
  • Phone: 828-389-8350
  • Fax: 828-389-9064

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: MS. MARY JANE PARKER
Title or Position: CEO/PRESIDENT
Credential:
Phone: 828-389-8350