# W I N G S COMMUNITY SUPPORT & RECOVERY SERVICES

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

## Provider details

- **NPI number:** 1881291672
- **Authorized official:** MRS. SPERLISHA VICTORIA AYENI (CHIEF OPERATIONS OFFICER)
- **Authorized official phone:** (270) 572-4132

## Contact information

- **Practice address:** 401 N MILES ST \# B101, ELIZABETHTOWN, KY 42701-1834
- **Practice address phone:** (270) 572-4132
- **Mailing address:** 5360 SONORA RD, HODGENVILLE, KY 42748-9663
- **Mailing address phone:** (270) 572-4132

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 175T00000X | Peer Specialist | — | NULL | — |
| 175T00000X | Peer Specialist | — | — | — |
| 261QR0401X | Comprehensive Outpatient Rehabilitation Facility (CORF) | — | NULL | Yes |

## Other

- **Enumeration date:** 10/05/2020
- **Last updated:** 02/05/2021