PARK PLACE
NPI 1962531079
Assisted Living Facility in O Fallon, MO

Q: What is Winghavenllc's NPI number?

The NPI number for Winghavenllc is 1962531079. It was assigned to this organization in the NPPES registry on March 5, 2007. The provider is doing business as Park Place.

Q: What is Winghavenllc's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Q: When was this NPI record last updated?

The NPPES record for Winghavenllc was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 05, 2007CLIA Certified · 2 labs

2002 BOARDWALK PLACE DR, O FALLON, MO 63368(636) 561-7275(636) 561-5304 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Park Place NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PARK PLACE (NPI 1962531079) is a healthcare organization registered as an assisted living facility in O Fallon, Missouri and active in the NPI registry since March 2007. The organization holds 2 active CLIA laboratory certificates and lists John B Gammon, General Manager, as its authorized official.

NPPES Registry Identity

NPI1962531079

Entity TypeOrganization

Primary Taxonomy310400000X

Legal Business NameWINGHAVENLLC

Location Address2002 BOARDWALK PLACE DRO Fallon, MO 63368-3900

Mailing Address2002 Boardwalk Place DrO Fallon, MO 63368-3900 · (636) 561-7275 · Fax (636) 561-5304

Phone(636) 561-7275

Fax(636) 561-5304

Organization SubpartNo

Authorized OfficialJohn B GammonGeneral Manager · (636) 625-2950

Enumeration DateMarch 5, 2007

Last NPPES UpdateAugust 22, 2020

✔ NPI 1962531079 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities

Taxonomy Code310400000X

Definition

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.

2002 BOARDWALK PLACE DR, O Fallon, MO 63368

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Other Names 1

Doing Business AsPark Place

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 26D1069281

Park Place Sr Living Assisted Living · O Fallon, MO

Active · expires May 30, 2027

CLIA Number26D1069281

Laboratory TypeAssisted Living Facility

Certificate Effective DateMay 31, 2025

Certificate Expiration DateMay 30, 2027

Laboratory DirectorKathy Stege

Laboratory Phone(636) 625-2914

Laboratory LocationPark Place Sr Living Assisted Living2002 Boardwalk Place Drive, O Fallon, MO 63368

CLIA data matches this NPI record on: Address Name

This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 26D2073991

Park Place Senior Living · O Fallon, MO

Active · expires Feb 26, 2028

CLIA Number26D2073991

Laboratory TypeAssisted Living Facility

Certificate Effective DateFebruary 27, 2026

Certificate Expiration DateFebruary 26, 2028

Laboratory DirectorDenise Caimi

Laboratory Phone(636) 625-2906

Laboratory LocationPark Place Senior Living2000 Boardwalk Place Drive, O Fallon, MO 63368

CLIA data matches this NPI record on: Name

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. ALIECE NICOLE BARKLAGE M.S. CCC-SLP

Speech-Language Pathologist

2002 BOARDWALK PLACE DR
OFALLON, MO 63368

St. Charles County (636) 625-2950

FIRST CAPITAL HOME HEALTH PARTNERS, LLC

Home Health

2002 BOARDWALK PLACE DR
O FALLON, MO 63368

St. Charles County (734) 560-8953

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Winghavenllc's NPI number?

The NPI number for Winghavenllc is 1962531079. It was assigned to this organization in the NPPES registry on March 5, 2007. The provider is doing business as Park Place.

Where is Winghavenllc located?

Winghavenllc is located at 2002 Boardwalk Place Dr, O Fallon, MO 63368. The listed phone number is (636) 561-7275.

What is Winghavenllc's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does Winghavenllc hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Winghavenllc was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.