Healthcare Provider Details
I. General information
NPI: 1689482028
Provider Name (Legal Business Name): THE FRUIT OF OUR HANDS MINISTRIES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/18/2024
Last Update Date: 12/18/2024
Certification Date: 12/18/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7000 INDIANA AVE STE 114
RIVERSIDE CA
92506-4155
US
IV. Provider business mailing address
7000 INDIANA AVE STE 114
RIVERSIDE CA
92506-4155
US
V. Phone/Fax
- Phone: 951-289-9808
- Fax:
- Phone: 951-289-9808
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171400000X |
| Taxonomy | Health & Wellness Coach |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171M00000X |
| Taxonomy | Case Manager/Care Coordinator |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 175T00000X |
| Taxonomy | Peer Specialist |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 405300000X |
| Taxonomy | Prevention Professional |
| License Number | |
| License Number State | |
| # 6 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 172V00000X |
| Taxonomy | Community Health Worker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MONICA
HUNTER
Title or Position: EXECUTIVE DIRECTOR
Credential: PHD
Phone: 951-201-0514