Provider Demographics
NPI:1831709476
Name:TWO WINGS COMMUNITY HEALTH SERVICES LLC
Entity type:Organization
Organization Name:TWO WINGS COMMUNITY HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:HOLLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-517-2396
Mailing Address - Street 1:1101 W OAK ST
Mailing Address - Street 2:
Mailing Address - City:AMITE
Mailing Address - State:LA
Mailing Address - Zip Code:70422-2751
Mailing Address - Country:US
Mailing Address - Phone:985-517-2396
Mailing Address - Fax:985-247-2173
Practice Address - Street 1:1101 W OAK ST
Practice Address - Street 2:
Practice Address - City:AMITE
Practice Address - State:LA
Practice Address - Zip Code:70422-2751
Practice Address - Country:US
Practice Address - Phone:985-517-2396
Practice Address - Fax:985-247-2173
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-07
Last Update Date:2020-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2518666Medicaid