Provider Demographics
NPI:1548854748
Name:OPEN WINGS INDEPENDENT LIVING, INC.
Entity type:Organization
Organization Name:OPEN WINGS INDEPENDENT LIVING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DWAN
Authorized Official - Middle Name:
Authorized Official - Last Name:EPPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-871-9191
Mailing Address - Street 1:2800 POST OAK BLVD STE 4100
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77056-6145
Mailing Address - Country:US
Mailing Address - Phone:832-253-1155
Mailing Address - Fax:832-253-1199
Practice Address - Street 1:2800 POST OAK BLVD STE 4100
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77056-6145
Practice Address - Country:US
Practice Address - Phone:832-253-1155
Practice Address - Fax:832-253-1199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-28
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No171R00000XOther Service ProvidersInterpreterGroup - Multi-Specialty
No251B00000XAgenciesCase Management
No310400000XNursing & Custodial Care FacilitiesAssisted Living FacilityGroup - Multi-Specialty
No3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness
No3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
No347C00000XTransportation ServicesPrivate Vehicle
No385H00000XRespite Care FacilityRespite CareGroup - Multi-Specialty