National Provider Identifier Database

WINGS OF LIFE MOBILE LLC
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities


Contact Information

WINGS OF LIFE MOBILE LLC
202 HOLLY ST
FRUITLAND, MD21826-2005
Phone: 410-726-6573
Fax:
Website:
Specialty Taxonomy Code
* Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities 320900000X
Home Health 251E00000X
Phlebotomy 246RP1900X

* Indicates primary specialty

NPI Profile & details for WINGS OF LIFE MOBILE LLC

NPI Number 1356896708
Legal business name
LBN
WINGS OF LIFE MOBILE LLC
Authorized official ZANDRA CEPHAS - (NATIONALLY CERTIFIED PHLEBOTOMIST)
Entity Organization
Organization subpart No
Enumeration date 08/15/2016
Last updated 09/13/2019 - About 7 years ago
Sole proprietor1 Not specified
Identifiers
  • MD License #: 681104140001

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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