Provider Demographics
NPI:1336464064
Name:UPLIFTING WINGS, LLC
Entity Type:Organization
Organization Name:UPLIFTING WINGS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MS
Authorized Official - First Name:APRENA
Authorized Official - Middle Name:
Authorized Official - Last Name:NOLLIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-598-7041
Mailing Address - Street 1:1757 JUNE DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63138-1028
Mailing Address - Country:US
Mailing Address - Phone:314-598-7041
Mailing Address - Fax:
Practice Address - Street 1:6907 PAGE AVE
Practice Address - Street 2:SUITE B
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63133-1507
Practice Address - Country:US
Practice Address - Phone:314-598-7041
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-06
Last Update Date:2010-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health