Healthcare Provider Details

I. General information

NPI: 1780700815
Provider Name (Legal Business Name): ADVENT GROUP MINISTRIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1960 CHURCH AVE GATEWAY
SAN MARTIN CA
95046
US

IV. Provider business mailing address

1960 CHURCH AVE GATEWAY
SAN MARTIN CA
95046-9656
US

V. Phone/Fax

Practice location:
  • Phone: 408-683-2099
  • Fax:
Mailing address:
  • Phone: 408-683-2099
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. MARK MILLER
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 408-281-0708