Organization
WINGS OF LIFE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHERRI LYNN SHORE-PERDUE (PRESIDENT)
(336) 674-5995
Entity
Organization
Contact information
Practice address
610 SPUR RD, GREENSBORO, NC 27406-8919
(336) 674-5995
(336) 674-0443
Mailing address
610 SPUR RD, GREENSBORO, NC 27406-8919
(336) 674-5995
(336) 674-0443
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
3409312
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3409312
—
NC
Enumeration date
09/06/2007
Last updated
09/06/2007
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