WINGHAVENLLC (NPI# 1962531079) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962531079 |
| Entity Type | Organization |
| Organization Name | WINGHAVENLLC |
| Other Organization Name | PARK PLACE |
| Practice Address |
2002 Boardwalk Place Dr O Fallon MO 63368-3900 |
| Practice Telephone | 6365617275 |
| Practice Fax Number | 6365615304 |
| Mailing Telephone | 6365617275 |
| Mailing Fax Number | 6365615304 |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. JOHN B GAMMON JR. (GENERAL MANAGER) |
| Authorized Official Telephone | 6366252950 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Park Place | Doing Business As Name - Organization |
| Street Address |
2002 BOARDWALK PLACE DR |
| City | O FALLON |
| State | MO |
| Zip Code | 63368-3900 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417244062 | First Capital Home Health Partners, LLC | Home Health | 2002 Boardwalk Place Dr, O Fallon, MO 63368-3901 | 2011-07-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134720329 | Come As You Are Counseling LLC | Counselor | 1001 Boardwalk Springs Place, Suite 111, O Fallon, MO 63368 | 2020-11-04 |
| 1770124802 | Lisa N. Greer | Technician | 6911 Brassel Dr., Ofallon, MO 63368 | 2019-09-30 |
| 1770145716 | Halie Faye Gulley | Dentist | 3009 Hwy K, O'fallon, MO 63368 | 2019-06-29 |
| 1972079556 | Erin Corsi Fraundorf | Dentist | 3009 State Hwy K, O'fallon, MO 63368 | 2018-10-22 |
| 1427579960 | Air Evac Ems, Inc. | Ambulance | 1001 Boardwalk Springs Pl Ste 250, O Fallon, MO 63368 | 2017-07-06 |
| 1528507472 | Washeck Manual Therapy LLC | Clinic/Center | 3074 Winghaven Blvd, O'fallon, MO 63368 | 2017-02-13 |
| 1639618457 | Brittany Hogan | Physical Therapist | 7412 South Outer 364, Suite B, Dardenne Prairie, MO 63368 | 2017-02-13 |
| 1124561469 | Cardinal Home Care LLC | Home Health | 18 Convent Garden Ct, O'fallon, MO 63368 | 2016-11-18 |
| 1336509272 | Sarah Marie Mudd | Counselor | 1654 Bryan Road, O'fallon, MO 63368 | 2016-03-04 |
| 1588023956 | Price-bourisaw Family Chiropractic | Chiropractor | 2917 State Highway K, O Fallon, MO 63368 | 2016-02-15 |
| Find all providers in zip 63368 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619386034 | Garden Villas of O'fallon, LLC | Assisted Living Facility | 7092 S Outer Road 364, O Fallon, MO 63368-7701 | 2014-08-11 |
| 1336311729 | Twin Oaks Estate, Inc | Assisted Living Facility | 707 Emge Rd, O Fallon, MO 63366-2118 | 2008-03-26 |
| 1932304789 | Cambridge House of Ofallon | Assisted Living Facility | 844 Cambridge Blvd, O Fallon, IL 62269-1976 | 2007-06-20 |
| 1548874951 | Colonnade Senior Development, LLC | Assisted Living Facility | 700 Weber Rd, O Fallon, IL 62269-2215 | 2020-09-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144820283 | Oak Meadows Rcf LLC | Assisted Living Facility | 5502 Misty Meadow Rd, Poplar Bluff, MO 63901-9287 | 2020-10-28 |
| 1700486859 | Hillcrest Residential Care | Assisted Living Facility | 9415 N North Browns Station Rd, Columbia, MO 65202-8671 | 2020-10-28 |
| 1700484250 | Americare At Field Pointe LLC | Assisted Living Facility | 5002 Gene Field Road, St Joseph, MO 64506 | 2020-10-15 |
| 1205433638 | Skyline Assisted Living LLC | Assisted Living Facility | 100 Hard Rock Rd, Van Buren, MO 63965-0780 | 2020-10-08 |
| 1023615622 | Four Seasons Care Corp | Assisted Living Facility | 230 Railroad St, Moscow Mills, MO 63362-1600 | 2020-10-06 |
| 1336754985 | Tiffany Springs Senior Care Community | Assisted Living Facility | 9101 N Ambassador Dr, Kansas City, MO 64154-7295 | 2020-09-10 |
| 1366053480 | Green Acres Assisted Living LLC | Assisted Living Facility | 411 N Kings Highway, Sikeston, MO 63801-1936 | 2020-08-12 |
| 1467062612 | Welcome Home Assisted Living, LLC | Assisted Living Facility | 5 Adams Dr, Dexter, MO 63841-1985 | 2020-08-03 |
| 1831725142 | Harmony Gardens Residential, LLC | Assisted Living Facility | 539 E Young Ave, Warrensburg, MO 64093-1228 | 2020-03-18 |
| 1386278414 | Family Partners Home LLC | Assisted Living Facility | 232 Creve Coeur Ave, Manchester, MO 63011-4040 | 2020-02-27 |
| Find all providers with the same taxonomy | ||||
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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.