Provider Demographics
NPI:1710312897
Name:WINGS OF HOPE HOSPICE AND PALLIATIVE CARE INC.,
Entity Type:Organization
Organization Name:WINGS OF HOPE HOSPICE AND PALLIATIVE CARE INC.,
Other - Org Name:WINGS OF HOPE HOSPICE AND PALLIATIVE CARE
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CAO/CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:KATZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-971-0304
Mailing Address - Street 1:11022 N 28TH DR STE 205
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85029-5635
Mailing Address - Country:US
Mailing Address - Phone:602-971-0304
Mailing Address - Fax:602-971-0305
Practice Address - Street 1:11022 N 28TH DR STE 205
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85029
Practice Address - Country:US
Practice Address - Phone:602-971-0304
Practice Address - Fax:602-971-0305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-09
Last Update Date:2018-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZHSPC6340251G00000X, 251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based