Healthcare Provider Details

I. General information

NPI: 1114727971
Provider Name (Legal Business Name): ON RAMPS COVENANT CHURCH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2025
Last Update Date: 03/19/2025
Certification Date: 03/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1955 BROADWAY ST
FRESNO CA
93721-1003
US

IV. Provider business mailing address

1955 BROADWAY ST
FRESNO CA
93721-1003
US

V. Phone/Fax

Practice location:
  • Phone: 559-930-5931
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number StateNULL
# 4
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: PHILIP SKEI
Title or Position: PASTOR EMERITUS
Credential:
Phone: 559-930-5931