Healthcare Provider Details

I. General information

NPI: 1245141472
Provider Name (Legal Business Name): IMPERFECT PEOPLE MINISTRIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26025 NEWPORT RD STE F-515
MENIFEE CA
92584-7393
US

IV. Provider business mailing address

26025 NEWPORT RD STE F-515
MENIFEE CA
92584-7393
US

V. Phone/Fax

Practice location:
  • Phone: 951-287-7993
  • Fax:
Mailing address:
  • Phone: 951-287-7993
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. ELZIE L WILLIS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 951-287-7993