# ANGEL WINGS COMMUNITY HEALTHCARE CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053099077
- **Authorized official:** LATOYA CAMERON FNP (OWNER)
- **Authorized official phone:** (601) 869-0299

## Contact information

- **Practice address:** 215 MAGNOLIA ST, MAGNOLIA, MS 39652-2827
- **Practice address phone:** (601) 869-0299
- **Practice address fax:** (601) 680-3216
- **Mailing address:** 215 MAGNOLIA ST, MAGNOLIA, MS 39652-2827
- **Mailing address phone:** (601) 869-0299
- **Mailing address fax:** (601) 680-3216

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/10/2023
- **Last updated:** 07/10/2023