Golden Wings Wendel

LBN: At Home Of Brevard, Llc.
Golden Wings Wendel is an health care organization with primary practice located at 3116 Wendel Rd Se , Palm Bay FL 32909-8469. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Assisted Living Facility, which is considered as the primary health care specialty. At Home Of Brevard, Llc. can be contacted via phone (321) 952-6623, or through Cullen, Michael Joseph via phone (321) 676-6331.

Contact Information

Primary practice address
3116 Wendel Rd Se Palm Bay FL 32909-8469
Phone: (321) 952-6623
Fax: (321) 952-6624
Website:
Map and Directions
Authorized official contact:
Name: Cullen, Michael Joseph
Phone: (321) 676-6331

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Assisted Living Facility 310400000X 10779 Florida

Profile Details

NPI number 1629244629
LBN Legal business name At Home Of Brevard, Llc.
DBA Doing business as Golden Wings Wendel
Authorized official Cullen, Michael Joseph
Entity Organization
Organization subpart 1 No
Enumeration date Apr 30th, 2008
Last updated Apr 30th, 2008 - about 18 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629244629 NPPES
Florida MEDICAID 6931120 00

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