NPIMap

Organization Active NPI

Wings of Refuge,Inc.

  • Exclusive Provider Organization
  • La Puente, CA
National Provider Identifier
1386940211
Registry record updated Feb 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Exclusive Provider OrganizationTaxonomy code 302F00000X
Legal business name
WINGS OF REFUGE,INC.
Practice address
904 Willow Ave
Room 2
La Puente, CA 91746-1615
Phone
(310) 670-6767
Fax
(310) 670-2626
NPI assigned
Feb 10, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2011

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

Authorized official

Name
Renee Moncito, PHD
Title
President & Ceo
Phone
(310) 670-6767

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Exclusive Provider Organization 302F00000X Primary

Addresses

Primary practice location

904 Willow Ave
Room 2
La Puente, CA 91746-1615

Mailing address

5777 W Century Blvd
Suite 910
Los Angeles, CA 90045-5600
Phone (310) 670-6767

Other names 1

  • Wings of Recovery-Nueva Vista Highschool Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Wings of Refuge18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

Organizations that report the same tax identification number in the National Provider Directory.

View all 17

Locations

904 Willow Ave
Rm 2
La Puente, CA 91746
Phone (310) 670-6767

NPI Registry JSON

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

{
    "created_epoch": "1297296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297296000000",
    "number": "1386940211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5777 W CENTURY BLVD",
            "address_2": "SUITE 910",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455600",
            "telephone_number": "310-670-6767",
            "fax_number": "310-670-2626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 WILLOW AVE",
            "address_2": "ROOM 2",
            "city": "LA PUENTE",
            "state": "CA",
            "postal_code": "917461615",
            "telephone_number": "310-670-6767",
            "fax_number": "310-670-2626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINGS OF REFUGE,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-10",
        "last_updated": "2011-02-10",
        "status": "A",
        "authorized_official_last_name": "MONCITO",
        "authorized_official_first_name": "RENEE",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "310-670-6767",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wings of Recovery-Nueva Vista Highschool",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in La Puente, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2011; 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.