NPIMap

Organization Active NPI

Angels Wings Synergy Retreat

  • Custodial Care Facility
  • Fort Pierce, FL
National Provider Identifier
1851779219
Registry record updated May 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Custodial Care FacilityTaxonomy code 311Z00000X
Legal business name
ANGELS WINGS SYNERGY RETREAT
Doing business as
angels wings synergy retreat
Practice address
1920 N 44TH St
Fort Pierce, FL 34947-1607
Phone
(559) 467-8888
NPI assigned
May 18, 2015
Last updated
May 18, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2015

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

Authorized official

Name
Mrs. Renee Michelle Gordon
Title
Owner Administrator
Phone
(559) 467-8888

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X FL
Custodial Care Facility 311Z00000X FL Primary
Inpatient Hospice 315D00000X FL
Respite Care 385H00000X FL

Addresses

Primary practice location

1920 N 44TH St
Fort Pierce, FL 34947-1607

Mailing address

1920 N 44TH St
Fort Pierce, FL 34947-1607
Phone (559) 467-8888

Other names 1

  • angels wings synergy retreat Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1431907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431907200000",
    "number": "1851779219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1920 N 44TH ST",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349471607",
            "telephone_number": "559-467-8888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 N 44TH ST",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349471607",
            "telephone_number": "559-467-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGELS WINGS SYNERGY RETREAT",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-18",
        "last_updated": "2015-05-18",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "RENEE",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "OWNER ADMINISTRATOR",
        "authorized_official_telephone_number": "559-467-8888",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": "FL",
            "license": null,
            "primary": true
        },
        {
            "code": "315D00000X",
            "taxonomy_group": "",
            "desc": "Hospice, Inpatient",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "FL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "angels wings synergy retreat",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Pierce, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2015; 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.