1265923130 NPI number — GODS CHILDREN MINISTRY HHA LLC

Table of content: (NPI 1265923130)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265923130 NPI number — GODS CHILDREN MINISTRY HHA LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GODS CHILDREN MINISTRY HHA LLC
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:
GODS CHILDREN MINISTRY HHA LLC
Provider Other Organization Name Type Code:
3
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:
1265923130
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3218 WAKEFIELD RD APT C
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HARRISBURG
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17109-6119
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-963-4447
Provider Business Mailing Address Fax Number:
717-233-1150

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
202 STATE ST STE 2
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HARRISBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17101-1103
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-610-3970
Provider Business Practice Location Address Fax Number:
717-233-1150
Provider Enumeration Date:
05/25/2018

Additional Information

Authorized Official

Authorized Official Last Name:
KINNARD
Authorized Official First Name:
REBECCA
Authorized Official Middle Name:
Authorized Official Title or Position:
MANAGER
Authorized Official Telephone Number:
717-608-4945

Provider Taxonomy Codes

  • Taxonomy code: 374U00000X , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 82359880 . This is a "HOME HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 8235980 . This is a "HOME HEALTH AGENCY" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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