NPIMap

Organization Active NPI

Wings of Life Mobile LLC

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Fruitland, MD
National Provider Identifier
1356896708
Registry record updated Sep 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
License
681104140001 Issued in MD
Legal business name
WINGS OF LIFE MOBILE LLC
Practice address
202 Holly St
Fruitland, MD 21826-2005
Phone
(410) 726-6573
NPI assigned
Aug 15, 2016
Last updated
Sep 13, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Zandra E Cephas, ASPT,CPTNPI 1780100735
Title
Nationally Certified Phlebotomist
Phone
(410) 726-6573

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X 681104140001 MD Primary
Phlebotomy Technician 246RP1900X

Addresses

Primary practice location

202 Holly St
Fruitland, MD 21826-2005

Mailing address

202 Holly St
Fruitland, MD 21826-2005
Phone (410) 726-6573

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL wingsoflife.biz

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1471219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568332800000",
    "number": "1356896708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 HOLLY ST",
            "city": "FRUITLAND",
            "state": "MD",
            "postal_code": "218262005",
            "telephone_number": "410-726-6573",
            "fax_number": "410-572-4143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 HOLLY ST",
            "city": "FRUITLAND",
            "state": "MD",
            "postal_code": "218262005",
            "telephone_number": "410-726-6573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINGS OF LIFE MOBILE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-15",
        "last_updated": "2019-09-13",
        "status": "A",
        "authorized_official_last_name": "CEPHAS",
        "authorized_official_first_name": "ZANDRA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "NATIONALLY CERTIFIED PHLEBOTOMIST",
        "authorized_official_telephone_number": "410-726-6573",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "ASPT,CPT"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "MD",
            "license": "681104140001",
            "primary": true
        },
        {
            "code": "246RP1900X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Phlebotomy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "wingsoflife.biz",
            "affiliation": "N",
            "address_1": "202 Holly St",
            "city": "Fruitland",
            "state": "MD",
            "country_code": "US",
            "postal_code": "218262005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fruitland, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.