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General NPI Number Information
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NPI Number | 1851862601
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Entity Type | Organization
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Legal Business Name | WINGS OF HOPE RECOVERY SERVICES INC
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Dates
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Enumeration Date | 12/05/2018
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Last Update Date | 12/05/2018
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Provider Practice Location Address
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Address Line | 2313 17TH ST
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City | PORTSMOUTH
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State | OH
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Zip | 45662-3223
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Country | US
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Telephone | 740-727-4801
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 287
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City | LEWIS CENTER
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State | OH
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Zip | 43035-0287
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Country | US
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Telephone | 614-289-8844
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Fax | 614-682-6901
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Authorized Official
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Title or Position | DIRECTOR
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Name | MAXINE MALONE
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Credential | CDCA
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Telephone | 740-727-4801
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3245S0500X
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Taxonomy Name | Children's Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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