NPI 1720385883

Wings of Refuge, INC.

Organisation Exclusive Provider Organization La Puente, CA

Practice location

Address: 14135 Fairgrove Ave, La Puente, CA 91746-1708
Phone: (310) 670-6767
Fax: (310) 670-2626
Mailing address: 5777 W Century Blvd Suite 910, Los Angeles, CA 90045-5600

Authorised official

Name: Renee Moncito
Title: President & Ceo
Phone: (310) 670-6767

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X

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Registry record

NPI: 1720385883
Entity type: Organization
NPI issued: 24 Feb 2011
Record last updated: 22 Mar 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.