| NPI | 1225321524 |
|---|---|
| Doing Business As | WINGS OF RECOVERY - NON RESIDENTIAL |
| Entity Type | Organization |
| Authorized Contact | RENEE MONCITO President & CEO 310-670-6767 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization |
| Enumeration Date | 2011-05-18 |
| Last Update Date | 2011-05-18 |