Provider Demographics
NPI:1942566781
Name:WINGS OF REFUGE, INC
Entity Type:Organization
Organization Name:WINGS OF REFUGE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:
Authorized Official - Last Name:MONCITO
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:310-709-8977
Mailing Address - Street 1:3730 KIRBY DR
Mailing Address - Street 2:SUITE 1200
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77098-3905
Mailing Address - Country:US
Mailing Address - Phone:713-831-6898
Mailing Address - Fax:713-831-6896
Practice Address - Street 1:3730 KIRBY DR
Practice Address - Street 2:SUITE 1200
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77098-3905
Practice Address - Country:US
Practice Address - Phone:713-831-6898
Practice Address - Fax:713-831-6896
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WINGS OF REFUGE, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-04-05
Last Update Date:2012-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1186386-6971253J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency