Provider Demographics
NPI:1154873628
Name:SPREAD YOUR WINGS HOME HEALTH
Entity type:Organization
Organization Name:SPREAD YOUR WINGS HOME HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ ALTERNATE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:RONNIE
Authorized Official - Middle Name:W
Authorized Official - Last Name:ALLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-683-9239
Mailing Address - Street 1:8723 DOSKOCIL DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77044-1157
Mailing Address - Country:US
Mailing Address - Phone:281-416-4069
Mailing Address - Fax:281-416-4069
Practice Address - Street 1:8723 DOSKOCIL DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77044-1157
Practice Address - Country:US
Practice Address - Phone:281-416-4069
Practice Address - Fax:281-416-4069
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-31
Last Update Date:2016-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health