MEDICARE: PIPELINE TO GOD COMMUNICATIONS, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251V00000X	Voluntary or Charitable Agency	1436740	OH
2	251S00000X	Community/Behavioral Health Agency	01-7543	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770811556
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PIPELINE TO GOD COMMUNICATIONS, INC.

Provider Business Mailing Address
First Line	:	23611 CHAGRIN BLVD STE 120
Second Line	:
City	:	BEACHWOOD
State	:	OH
Zip	:	44122-5540
Country	:	US
Telephone Number	:	216-360-9343
Fax Number	:	216-360-9345

Provider Business Practice Location Address
First Line	:	23611 CHAGRIN BLVD STE 120
Second Line	:
City	:	BEACHWOOD
State	:	OH
Zip	:	44122-5540
Country	:	US
Telephone Number	:	216-360-9343
Fax Number	:	216-360-9345

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	IRIS LYNN BAILEY
Credential	:	M-DIV,, M.A,, LPCC-S
Telephone Number	:	216-360-9343

Provider Enumeration Date	:	12/06/2009
Last Update Date	:	01/14/2016

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