| NPI | 1649577206 |
|---|---|
| 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 | 2011-02-17 |
| Last Update Date | 2011-02-17 |