1871666412 NPI number — CHURCH OF LOVING HANDS, INC.

Table of content: (NPI 1871666412)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871666412 NPI number — CHURCH OF LOVING HANDS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHURCH OF LOVING HANDS, INC.
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:
1871666412
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
111 ORCHARD AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CARLOTTA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95528-9733
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
707-725-9627
Provider Business Mailing Address Fax Number:
707-725-2471

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
639 11TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FORTUNA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95540-2346
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
707-725-9627
Provider Business Practice Location Address Fax Number:
707-725-2471
Provider Enumeration Date:
11/15/2006

Additional Information

Authorized Official

Authorized Official Last Name:
OJALA
Authorized Official First Name:
ROSALIND
Authorized Official Middle Name:
SKYHAWK
Authorized Official Title or Position:
ADMINISTRATIVE DIRECTOR
Authorized Official Telephone Number:
707-725-9627

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  ABMP#106753 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: ABMP#106753 . This is a "ABMP MASSAGE THERAPIST" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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