Provider Demographics
NPI:1144464629
Name:HEALING WINGS HOME HEALTH, LLC
Entity type:Organization
Organization Name:HEALING WINGS HOME HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MELINDA
Authorized Official - Middle Name:L
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-777-4494
Mailing Address - Street 1:5411 N UNIVERSITY DR STE 202
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33067-4637
Mailing Address - Country:US
Mailing Address - Phone:866-777-4494
Mailing Address - Fax:954-346-4556
Practice Address - Street 1:5411 N UNIVERSITY DR STE 202
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33067-4637
Practice Address - Country:US
Practice Address - Phone:866-777-4494
Practice Address - Fax:954-346-4556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-28
Last Update Date:2009-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299993408251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health