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General NPI Number Information
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NPI Number | 1467727974
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Entity Type | Organization
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Legal Business Name | WINGS ADULT SERVICES
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Dates
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Enumeration Date | 03/16/2012
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Last Update Date | 03/16/2012
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Provider Practice Location Address
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Address Line | 35 EXECUTIVE PARK DR STE C
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City | HENDERSONVILLE
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State | TN
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Zip | 37075-3486
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Country | US
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Telephone | 615-431-2243
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Fax | 615-431-2972
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Provider Business Mailing Address
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Address Line | 35 EXECUTIVE PARK DR STE C
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City | HENDERSONVILLE
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State | TN
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Zip | 37075-3486
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Country | US
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Telephone | 615-431-2243
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Fax | 615-431-2972
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. BETTYE ANN SHIPP
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Credential | B.S
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Telephone | 615-431-2243
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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