Organization
WINGS OF LIFE MOBILE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ZANDRA E CEPHAS ASPT,CPT (NATIONALLY CERTIFIED PHLEBOTOMIST)
(410) 726-6573
Entity
Organization
Contact information
Practice address
202 HOLLY ST, FRUITLAND, MD 21826-2005
(410) 726-6573
Mailing address
202 HOLLY ST, FRUITLAND, MD 21826-2005
(410) 726-6573
(410) 572-4143
Taxonomy
Speciality
Code
Description
License number
State
246RP1900X
Phlebotomy Technician
—
—
251E00000X
Home Health Agency
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
681104140001
MD
Other
Enumeration date
08/15/2016
Last updated
09/13/2019
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