Wings Of Refuge,inc.
Exclusive Provider Organization in La Puente, CA. Organization (NPI-2).
NPI number1386940211
StatusActive
Last updated in NPPESFeb 10, 2011
Details
- NPI
- 1386940211
- Entity type
- Organization (NPI-2)
- Legal business name
- Wings Of Refuge,inc.
- Organization subpart
- No
- Enumeration date
- Feb 10, 2011
- Last updated
- Feb 10, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 302F00000X | Exclusive Provider Organization | – | – | Yes |
Other names
- Wings Of Recovery-Nueva Vista Highschool (Doing Business As)
Practice location
904 Willow AveRoom 2
La Puente, CA 91746-1615
Phone 310-670-6767 · Fax 310-670-2626
Mailing address
5777 W Century BlvdSuite 910
Los Angeles, CA 90045-5600
Phone 310-670-6767 · Fax 310-670-2626
Authorized official
Renee Moncito
President & Ceo
3106706767
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