Healthcare Provider Details

I. General information

NPI: 1356715601
Provider Name (Legal Business Name): SET UP MINISTRIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/24/2015
Last Update Date: 11/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

122 N ELM ST SUITE M-16 (216)
GREENSBORO NC
27401-2878
US

IV. Provider business mailing address

122 N ELM ST SUITE M-16 (216)
GREENSBORO NC
27401-2878
US

V. Phone/Fax

Practice location:
  • Phone: 336-346-9690
  • Fax:
Mailing address:
  • Phone: 336-346-9690
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. CYNTHIA DIANNE WALKER
Title or Position: EXECUTIVE DIRECTOR
Credential: AAS, BSW, MA
Phone: 336-346-9690