Healthcare Provider Details

I. General information

NPI: 1780033175
Provider Name (Legal Business Name): COMPASSIONATE HEARTS MINISTRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2016
Last Update Date: 06/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5709 GOODLAND TRCE
ALEXANDRIA LA
71301-2655
US

IV. Provider business mailing address

5709 GOODLAND TRCE
ALEXANDRIA LA
71301-2655
US

V. Phone/Fax

Practice location:
  • Phone: 318-308-3773
  • Fax:
Mailing address:
  • Phone: 318-308-3773
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name: BARBARA A TERRELL
Title or Position: OWNER
Credential:
Phone: 318-308-3773