Healthcare Provider Details

I. General information

NPI: 1083885511
Provider Name (Legal Business Name): THE CHARIS HEALING MINISTRIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2008
Last Update Date: 03/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11776 W SAMPLE RD SUITE 104
CORAL SPRINGS FL
33065-3180
US

IV. Provider business mailing address

11776 W SAMPLE RD SUITE 104
CORAL SPRINGS FL
33065-3180
US

V. Phone/Fax

Practice location:
  • Phone: 954-753-0467
  • Fax:
Mailing address:
  • Phone: 954-753-0467
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State

VIII. Authorized Official

Name: PAUL J SCHWEINLER
Title or Position: DIRECTOR
Credential: MDIV
Phone: 954-753-0467