The W.I.N.G.S Adult Family Home LLC

Primary specialty

Assisted Living Facility (Behavioral Disturbances)Taxonomy code 3104A0630X

Legal business name

THE W.I.N.G.S ADULT FAMILY HOME LLC

Doing business as

The WINGS AFH

Practice address

2804 Rosalind Ave
Racine, WI 53403-3760

Phone

(262) 456-0336

Fax

(262) 456-0336

NPI assigned

Aug 31, 2024

Last updated

Sep 4, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tonya Witherspoon

Title

Director

Phone

(262) 321-8216

Specialties & licenses 1

Addresses

Other names 1

• The WINGS AFH Doing business as

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

{
    "created_epoch": "1725062400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725408000000",
    "number": "1841024718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 85354",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534085354",
            "fax_number": "262-456-0336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2804 ROSALIND AVE",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534033760",
            "telephone_number": "262-456-0336",
            "fax_number": "262-456-0336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE W.I.N.G.S ADULT FAMILY HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-31",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A",
        "authorized_official_last_name": "WITHERSPOON",
        "authorized_official_first_name": "TONYA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "262-321-8216"
    },
    "taxonomies": [
        {
            "code": "3104A0630X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Behavioral Disturbances",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The WINGS AFH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility (Behavioral Disturbances) in Racine, WI
• Providers in Racine, WI by specialty
• Assisted Living Facility (Behavioral Disturbances) in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2024; 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.