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Organization

SPREAD YOUR WINGS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ANDREW SERRY DUMBUYA (CEO)
(408) 401-2984
Entity
Organization

Contact information

Practice address
150 N JACKSON AVE STE 10, SAN JOSE, CA 95116-1908
Mailing address
96 W 2ND ST, MORGAN HILL, CA 95037-4504

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
261QM0850X
Adult Mental Health Clinic/Center
Primary
261QM0855X
Adolescent and Children Mental Health Clinic/Center

Other

Enumeration date
07/23/2018
Last updated
07/23/2018
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