Provider Demographics
NPI:1174059471
Name:WINGS OF A DOVE FOUNDATION
Entity type:Organization
Organization Name:WINGS OF A DOVE FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CHARMAINE
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:RDH
Authorized Official - Phone:917-698-5479
Mailing Address - Street 1:2070 E 57TH ST
Mailing Address - Street 2:2 ND FLOOR
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-4702
Mailing Address - Country:US
Mailing Address - Phone:917-698-5479
Mailing Address - Fax:
Practice Address - Street 1:2070 E 57TH ST
Practice Address - Street 2:2 ND FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-4702
Practice Address - Country:US
Practice Address - Phone:917-698-5479
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-05
Last Update Date:2017-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable