Healthcare Provider Details

I. General information

NPI: 1053581025
Provider Name (Legal Business Name): GARDNER YATES MINISTRIES,INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2008
Last Update Date: 03/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 VALLEY BROOK DR
FRANKFORT KY
40601-4263
US

IV. Provider business mailing address

114 VALLEY BROOK DR
FRANKFORT KY
40601-4263
US

V. Phone/Fax

Practice location:
  • Phone: 502-330-9055
  • Fax:
Mailing address:
  • Phone: 502-330-9055
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. GARDNER G YATES
Title or Position: CEO/PROGRAM ADMINISTRATOR
Credential: CLERGY
Phone: 502-330-9055