Provider Demographics
NPI:1558032938
Name:WINGS RECOVERY CENTER, INC.
Entity Type:Organization
Organization Name:WINGS RECOVERY CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:KATY
Authorized Official - Middle Name:
Authorized Official - Last Name:HOSLAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-220-9519
Mailing Address - Street 1:785 GRAND AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-2370
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2217 BROOKHAVEN PASS
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92081-8333
Practice Address - Country:US
Practice Address - Phone:619-320-5150
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WINGS RECOVERY CENTER, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-09-24
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness