1649888157 NPI number — ONE TOUCH OF CHRIST EVANGELISTIC MINISTRIES

Table of content: (NPI 1649888157)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649888157 NPI number — ONE TOUCH OF CHRIST EVANGELISTIC MINISTRIES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ONE TOUCH OF CHRIST EVANGELISTIC 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:
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:
1649888157
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3160 E MT RAINIER DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ONTARIO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91762-7272
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
612-328-4819
Provider Business Mailing Address Fax Number:
763-762-6537

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
350 VINTON AVE STE 102
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
POMONA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91767-3000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
612-328-4819
Provider Business Practice Location Address Fax Number:
763-762-6537
Provider Enumeration Date:
07/21/2020

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
GREENE
Authorized Official First Name:
CHRISTIANA
Authorized Official Middle Name:
Authorized Official Title or Position:
CHAIRMAN
Authorized Official Telephone Number:
612-328-4819

Provider Taxonomy Codes

  • Taxonomy code: 261QM0850X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QR0405X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1992366645 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".