Active NPI
La Wings Home Health Care Inc.
- Home Health Agency
- Saint Louis, MO
National Provider Identifier
1376616003
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- License
- LC6681870
- Legal business name
- LA WINGS HOME HEALTH CARE INC.
- Practice address
- 4030 Cottage Ave
Saint Louis, MO 63113-3204 - Phone
- (314) 531-8594
- Fax
- (314) 531-8596
- NPI assigned
- Nov 17, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Delores Jean Wings
- Title
- Director
- Phone
- (314) 531-8594
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | LC6681870 | MO | Primary |
Addresses
Primary practice location
4030 Cottage Ave
Saint Louis, MO 63113-3204
Mailing address
4030 Cottage Ave
Saint Louis, MO 63113-3204
Phone (314) 531-8594
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0004668 | Medicaid | MO | |
| 283839702 | Medicaid | MO | |
| 263839706 | Medicaid | MO |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163721600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1245801600000",
"number": "1376616003",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4030 COTTAGE AVE",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631133204",
"telephone_number": "314-531-8594",
"fax_number": "314-531-8596"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4030 COTTAGE AVE",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631133204",
"telephone_number": "314-531-8594",
"fax_number": "314-531-8596"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LA WINGS HOME HEALTH CARE INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-11-17",
"last_updated": "2009-06-24",
"status": "A",
"authorized_official_last_name": "WINGS",
"authorized_official_first_name": "DELORES",
"authorized_official_middle_name": "JEAN",
"authorized_official_title_or_position": "DIRECTOR",
"authorized_official_telephone_number": "314-531-8594"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "MO",
"license": "LC6681870",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0004668",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "283839702",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "263839706",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.