Provider Demographics
NPI: | 1396953097 |
---|---|
Name: | WINGS OF HOPE INC |
Entity type: | Organization |
Organization Name: | WINGS OF HOPE INC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | CEO PRESIDENT |
Authorized Official - Prefix: | |
Authorized Official - First Name: | SAMANTHA |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | ADAMS |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 502-413-7360 |
Mailing Address - Street 1: | 8509 BURLINGAME RD |
Mailing Address - Street 2: | |
Mailing Address - City: | LOUISVILLE |
Mailing Address - State: | KY |
Mailing Address - Zip Code: | 40219-5280 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 502-413-7360 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 8509 BURLINGAME RD |
Practice Address - Street 2: | |
Practice Address - City: | LOUISVILLE |
Practice Address - State: | KY |
Practice Address - Zip Code: | 40219-5280 |
Practice Address - Country: | US |
Practice Address - Phone: | 502-413-7360 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2007-05-18 |
Last Update Date: | 2009-02-11 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 251B00000X | Agencies | Case Management | ||
No | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | Mental Health | Group - Multi-Specialty |
No | 133N00000X | Dietary & Nutritional Service Providers | Nutritionist | Group - Multi-Specialty | |
No | 251C00000X | Agencies | Day Training, Developmentally Disabled Services | ||
No | 251E00000X | Agencies | Home Health | ||
No | 251V00000X | Agencies | Voluntary or Charitable | ||
No | 320600000X | Residential Treatment Facilities | Residential Treatment Facility, Intellectual and/or Developmental Disabilities | ||
No | 320800000X | Residential Treatment Facilities | Community Based Residential Treatment Facility, Mental Illness | ||
No | 320900000X | Residential Treatment Facilities | Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | ||
No | 322D00000X | Residential Treatment Facilities | Residential Treatment Facility, Emotionally Disturbed Children | ||
No | 343900000X | Transportation Services | Non-emergency Medical Transport (VAN) | ||
No | 347C00000X | Transportation Services | Private Vehicle | ||
No | 385H00000X | Respite Care Facility | Respite Care | ||
No | 385HR2060X | Respite Care Facility | Respite Care | Respite Care, Intellectual and/or Developmental Disabilities, Child | |
No | 385HR2065X | Respite Care Facility | Respite Care | Respite Care, Physical Disabilities, Child |