Provider Demographics
NPI:1215394226
Name:WINGS OF HOPE HOSPICE, INC
Entity Type:Organization
Organization Name:WINGS OF HOPE HOSPICE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LILIBETH
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON-MEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-307-0089
Mailing Address - Street 1:345 W PEARL AVE
Mailing Address - Street 2:STE 240
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92374-3174
Mailing Address - Country:US
Mailing Address - Phone:909-307-0089
Mailing Address - Fax:909-335-1118
Practice Address - Street 1:345 W. PEARL AVENUE
Practice Address - Street 2:STE 240
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92374-3174
Practice Address - Country:US
Practice Address - Phone:909-307-0089
Practice Address - Fax:909-335-1118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-21
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based