Provider Demographics
NPI:1023389285
Name:WINGS OF ASPIRATIONS
Entity Type:Organization
Organization Name:WINGS OF ASPIRATIONS
Other - Org Name:CARING FOR THE COMMUNITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BABOONIE
Authorized Official - Middle Name:
Authorized Official - Last Name:TATUM
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:414-915-8189
Mailing Address - Street 1:732 W MELVINA ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53206-3342
Mailing Address - Country:US
Mailing Address - Phone:414-915-8189
Mailing Address - Fax:414-763-3472
Practice Address - Street 1:7915 W APPLETON AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53218-4500
Practice Address - Country:US
Practice Address - Phone:414-915-8189
Practice Address - Fax:414-763-3472
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-19
Last Update Date:2012-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management