1922985340 NPI number — W.I.N.G.S OF AMERICA LLC

NPI Number: 1922985340
Health Care Provider/Practitioner: W.I.N.G.S OF AMERICA LLC

NPI Number : 1922985340 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1922985340",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "W.I.N.G.S OF AMERICA LLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "3333 W 116TH ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "INGLEWOOD",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "90303-3005",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "310-940-4624",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "3355 W 117TH ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "INGLEWOOD",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "90303-3007",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "310-940-4624",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "08/18/2025",
    "LastUpdateDate": "08/18/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "WALLACE",
    "AuthorizedOfficialFirstName": "HENRY",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "MANAGER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "310-940-4624",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "251B00000X",
          "TaxonomyName": "Case Management Agency",
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          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
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          "TaxonomyName": "Home Health Agency",
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          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "251F00000X",
          "TaxonomyName": "Home Infusion Agency",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "251J00000X",
          "TaxonomyName": "Nursing Care Agency",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "251S00000X",
          "TaxonomyName": "Community/Behavioral Health Agency",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "253Z00000X",
          "TaxonomyName": "In Home Supportive Care Agency",
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          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "261QR0401X",
          "TaxonomyName": "Comprehensive Outpatient Rehabilitation Facility (CORF)",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "3104A0625X",
          "TaxonomyName": "Assisted Living Facility (Mental Illness)",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "3104A0630X",
          "TaxonomyName": "Assisted Living Facility (Behavioral Disturbances)",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "311ZA0620X",
          "TaxonomyName": "Adult Care Home Facility",
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          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "320700000X",
          "TaxonomyName": "Physical Disabilities Residential Treatment Facility",
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          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "332U00000X",
          "TaxonomyName": "Home Delivered Meals",
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          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
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          "TaxonomyName": "Respite Care",
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          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
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          "LicenseNumberStateCode": null,
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        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}