Provider Demographics
NPI:1467727974
Name:WINGS ADULT SERVICES
Entity Type:Organization
Organization Name:WINGS ADULT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BETTYE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SHIPP
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:615-431-2243
Mailing Address - Street 1:35 EXECUTIVE PARK DR STE C
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-3486
Mailing Address - Country:US
Mailing Address - Phone:615-431-2243
Mailing Address - Fax:615-431-2972
Practice Address - Street 1:35 EXECUTIVE PARK DR STE C
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-3486
Practice Address - Country:US
Practice Address - Phone:615-431-2243
Practice Address - Fax:615-431-2972
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-16
Last Update Date:2012-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty