Provider Demographics
NPI:1194533570
Name:WINGS RECOVERY CENTER, INC.
Entity type:Organization
Organization Name:WINGS RECOVERY CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KATY
Authorized Official - Middle Name:
Authorized Official - Last Name:HOSLAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-220-9519
Mailing Address - Street 1:785 GRAND AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-2370
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5422 WELLESLEY ST W
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-1772
Practice Address - Country:US
Practice Address - Phone:615-630-2065
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WINGS RECOVERY CENTER, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-12-18
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility