Organization
WINGHAVENLLC
Active
Organization
WINGHAVENLLC
Active
Other names
Park Place
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN B GAMMON JR. (GENERAL MANAGER)
(636) 625-2950
Entity
Organization
Contact information
Practice address
2002 BOARDWALK PLACE DR, O FALLON, MO 63368-3900
(636) 561-7275
(636) 561-5304
Mailing address
2002 BOARDWALK PLACE DR, O FALLON, MO 63368-3900
(636) 561-7275
(636) 561-5304
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
03/05/2007
Last updated
08/22/2020
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