Provider Demographics
NPI:1508759036
Name:HEALING WINGS WELLNESS CENTER
Entity type:Organization
Organization Name:HEALING WINGS WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHAKEEMIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANIFOWOSHE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-703-9788
Mailing Address - Street 1:5552 MESQUITE CREEK ST
Mailing Address - Street 2:
Mailing Address - City:N LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89031-6835
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5552 MESQUITE CREEK ST
Practice Address - Street 2:
Practice Address - City:N LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89031-6835
Practice Address - Country:US
Practice Address - Phone:702-703-9788
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-02
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral Health