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General NPI Number Information
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NPI Number | 1053746875
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Entity Type | Organization
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Legal Business Name | WINGS 4 HOPE ADULT CARE SERVICES INC.
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Dates
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Enumeration Date | 09/11/2013
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Last Update Date | 12/23/2014
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Provider Practice Location Address
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Address Line | 16712 N 113TH DR
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City | SURPRISE
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State | AZ
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Zip | 85378-9316
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Country | US
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Telephone | 813-601-1676
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Fax |
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Provider Business Mailing Address
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Address Line | 16712 N 113TH DR
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City | SURPRISE
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State | AZ
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Zip | 85378-9316
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Country | US
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Telephone | 813-601-1676
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DORENDA DURR
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Credential |
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Telephone | 813-601-1676
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State | AZ
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