Organization
WINGS OF REFUGE INC
Active
Other names
Wings of Recovery-John Marshall High School
Organization subpart
No
Provider details
NPI number
Authorized official
RENEE G MONCITO (PRESIDENT & CEO)
(310) 670-6767
Entity
Organization
Contact information
Practice address
3939 TRACY ST, LOS ANGELES, CA 90027-3207
(323) 671-1400
(323) 665-8682
Mailing address
5777 W CENTURY BLVD, SUITE 910, LOS ANGELES, CA 90045-5600
(310) 670-6767
(310) 670-2626
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
—
—
Other
Enumeration date
10/19/2011
Last updated
10/19/2011
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