HEAVENLY ANGEL WINGS RETIREMENT HOME (NPI# 1174958474) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174958474 |
| Entity Type | Organization |
| Organization Name | HEAVENLY ANGEL WINGS RETIREMENT HOME |
| Practice Address |
8404 Knifley Rd Columbia KY 42728-7505 |
| Practice Telephone | 2702504051 |
| Mailing Telephone | 2702504051 |
| Enumeration Date | 2013-09-05 |
| Last Update Date | 2013-09-05 |
| Authorized Official Name | CHARLES CRAWHORN (CEO) |
| Authorized Official Telephone | 2702504051 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320700000X | Residential Treatment Facility, Physical Disabilities | KY | Residential Treatment Facilities |
| Street Address |
8404 KNIFLEY RD |
| City | COLUMBIA |
| State | KY |
| Zip Code | 42728-7505 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598234114 | Spectrum Care Academy Bluegrass 2 | Psychiatric Residential Treatment Facility | 1175 Cane Valley Rd., Columbia, KY 42728 | 2018-11-14 |
| 1588176812 | Yuichi Kitagawa | Family Medicine | 803 Burksville St, Columbia, KY 42728 | 2017-10-26 |
| 1265983118 | Samantha Giles | Occupational Therapist | 700 Coy Trce, Columbia, KY 42728 | 2016-10-16 |
| 1164804720 | Cumberland Family Medical Center, Inc. | Clinic/Center | 158 Colonel Casey Drive, Columbia, KY 42728 | 2015-06-19 |
| 1164812509 | Eric Henderson Coomer | Registered Nurse | 85 Downey Drive, Columbia, KY 42728 | 2015-01-23 |
| 1154742518 | Mckinsey C Matney | Speech-Language Pathologist | 638 Huntington Way, Columbia, KY 42728 | 2014-01-02 |
| 1619309861 | Lake Cumberland District Health Department | Public Health or Welfare | 158 Col Casey Drive, Columbia, KY 42728 | 2013-07-30 |
| 1184872475 | Wal-mart Stores, Inc. | Eyewear Supplier (Equipment, not the service) | 2988 Burkesville Rd., Columbia, KY 42728 | 2008-08-29 |
| 1346412301 | Adair County Hospital District | Home Health | 904-b Westlake Drive, Columbia, KY 42728 | 2008-03-31 |
| 1922207513 | Columbia Medical Equipment, Inc. | Durable Medical Equipment & Medical Supplies | 937 Campbellsville Road, Columbia, KY 42728 | 2007-07-13 |
| Find all providers in zip 42728 | ||||
| Taxonomy Code | 320700000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Physical Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346897022 | D'ovionne Nydasia Potter | Residential Treatment Facility, Physical Disabilities | 202 Chapman Ln, Columbia, TN 38401-2622 | 2019-08-19 |
| 1912345596 | Mcmillian's Community Care Home | Residential Treatment Facility, Physical Disabilities | 5748 Knightner St, Columbia, SC 29203-3508 | 2013-06-05 |
| 1871717264 | Humanim Inc | Residential Treatment Facility, Physical Disabilities | 6355 Woodside Ct, Columbia, MD 21046-1071 | 2007-04-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689050916 | Victoria's Dream, LLC | Residential Treatment Facility, Physical Disabilities | 8345 Bloomfield Rd, Bloomfield, KY 40008-7000 | 2015-08-10 |
| 1871841114 | Premier Therapy Care | Residential Treatment Facility, Physical Disabilities | 330 Eastern Byp, Suite 145, Richmond, KY 40475-2562 | 2012-08-16 |
| 1770762833 | Commonwealth of Kentucky | Residential Treatment Facility, Physical Disabilities | 5659 Main St, Thelma, KY 41260-8609 | 2007-10-25 |
| 1154341923 | Masonic Homes of Kentucky Inc | Residential Treatment Facility, Physical Disabilities | 240 Masonic Home Dr, Masonic Home, KY 40041-9000 | 2006-07-21 |
| 1497256770 | New Vista Behavioral Healthcare Inc. | Residential Treatment Facility, Physical Disabilities | 1351 Newtown Pike Bldg 1, Lexington, KY 40511-1277 | 2018-02-22 |
| 1366810434 | Rehabcare Group East Inc. | Residential Treatment Facility, Physical Disabilities | 680 S 4th St, Louisville, KY 40202-2407 | 2015-09-08 |
| 1962776443 | Sundance Rehabilitation | Residential Treatment Facility, Physical Disabilities | 7300 Woodspoint Drive, Florence, KY 41042 | 2012-03-01 |
| 1619013901 | Eldridge-keelin Chiropractic Pllc | Residential Treatment Facility, Physical Disabilities | 1320 Wolohan Dr, Ashland, KY 41102-8940 | 2007-01-30 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.