Healthcare Provider Details

I. General information

NPI: 1609021500
Provider Name (Legal Business Name): NEIGHBORHOOD OUTREACH COMMUNITY CHURCH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2008
Last Update Date: 11/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8860 GOMBERG CT
MILAN MI
48160-9747
US

IV. Provider business mailing address

8860 GOMBERG CT
MILAN MI
48160-9747
US

V. Phone/Fax

Practice location:
  • Phone: 734-829-7124
  • Fax:
Mailing address:
  • Phone: 734-829-7124
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code177F00000X
TaxonomyLodging Provider
License Number
License Number State

VIII. Authorized Official

Name: MRS. SYLVIA VIVIAN HOOD
Title or Position: CEO
Credential:
Phone: 734-829-7124