1023356292 NPI number — REMNANT OF CHRIST KINGDOM MINISTRIES

Table of content: MS. JINA ELAINE PROCTOR LICSW (NPI 1316374333)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023356292 NPI number — REMNANT OF CHRIST KINGDOM MINISTRIES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
REMNANT OF CHRIST KINGDOM MINISTRIES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1023356292
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/23/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P.O. BOX 1974
Provider Second Line Business Mailing Address:
3791 CHARLESTON HWY
Provider Business Mailing Address City Name:
ORANGEBURG
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29115
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
803-465-1238
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3791 CHARLESTON HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ORANGEBURG
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29115
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
803-465-1238
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/23/2013

Additional Information

Authorized Official

Authorized Official Last Name:
COLEMAN
Authorized Official First Name:
DEARIE
Authorized Official Middle Name:
Y
Authorized Official Title or Position:
SERVANT/DISCIPLE OF JESUS CHRIST
Authorized Official Telephone Number:
803-465-1238

Provider Taxonomy Codes

  • Taxonomy code: 251V00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com