WINGSPAN LIFE RESOURCES NPI 1871641373

NPI Information

NPI: 1871641373
Provider Name: WINGSPAN LIFE RESOURCES
Classification: Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320600000X
Entity Type: Organization
Address:
30 PLATO BLVD E
SAINT PAUL, MN
ZIP 55107
Phone: (651) 242-5840
Get Directions

WINGSPAN LIFE RESOURCES is a residential treatment facility, intellectual and/or developmental disabilities in Saint Paul, MN. The provider is a residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently. WINGSPAN LIFE RESOURCES NPI is 1871641373. The provider is registered as an organization entity type.

The provider's business location address is:

30 PLATO BLVD E
SAINT PAUL, MN
ZIP 55107-809
Phone: (651) 242-5840

The provider's authorized official is Therese G Davis .
The authorized official title is Executive Director and has the following contact phone number (651) 242-5840.

The enumeration date for this NPI number is 1/8/2007 and was last updated on 6/24/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	320600000X	Residential Treatment Facility, Intellectual and/or Developmental Disabilities		HFID 01287	MINNESOTA	No
2	320600000X	Residential Treatment Facility, Intellectual and/or Developmental Disabilities		HFID 01198	MINNESOTA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	047148000	OTHER	MINNESOTA	ICFMR - MARSHALL
2	014245000	OTHER	MINNESOTA	ICFMR - 91ST STR

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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