Organization Active NPI

La Wings Home Health Care Inc.

  • Home Health Agency
  • Saint Louis, MO
National Provider Identifier
1376616003
Registry record updated Jun 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
LC6681870 Issued in MO
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

Updated by the provider on Jun 24, 2009

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
0004668MedicaidMO
283839702MedicaidMO
263839706MedicaidMO

National Provider Directory

National Provider Directory

NPI 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.

Verify at the official NPI Registry.