Provider Demographics
NPI:1306249073
Name:WINGS OF HOPE HOSPICE AND PALLIATIVE CARE INC.
Entity type:Organization
Organization Name:WINGS OF HOPE HOSPICE AND PALLIATIVE CARE INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:LYNN
Authorized Official - Suffix:
Authorized Official - Credentials:RN, LMSW
Authorized Official - Phone:269-686-8659
Mailing Address - Street 1:530 LINN ST
Mailing Address - Street 2:
Mailing Address - City:ALLEGAN
Mailing Address - State:MI
Mailing Address - Zip Code:49010-1562
Mailing Address - Country:US
Mailing Address - Phone:269-686-8659
Mailing Address - Fax:269-686-9643
Practice Address - Street 1:530 LINN ST
Practice Address - Street 2:
Practice Address - City:ALLEGAN
Practice Address - State:MI
Practice Address - Zip Code:49010-1562
Practice Address - Country:US
Practice Address - Phone:269-686-8659
Practice Address - Fax:269-686-9643
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-08
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative MedicineGroup - Single Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty