Provider Demographics
NPI:1629441571
Name:W.I.N.G.S., LLC
Entity Type:Organization
Organization Name:W.I.N.G.S., LLC
Other - Org Name:W.I.N.G.S., LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:LAMENDOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-585-3351
Mailing Address - Street 1:6584 LANDOVER BLVD
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34608-1313
Mailing Address - Country:US
Mailing Address - Phone:352-585-3351
Mailing Address - Fax:352-596-6141
Practice Address - Street 1:6584 LANDOVER BLVD
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34608-1313
Practice Address - Country:US
Practice Address - Phone:352-585-3351
Practice Address - Fax:352-596-6141
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-01
Last Update Date:2016-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251C00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL016012200Medicaid
FL599689Medicaid
FL605974Medicaid