Healthcare Provider Details
I. General information
NPI: 1740045095
Provider Name (Legal Business Name): CHRISTIAN BELIEVERS EDUCATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/15/2024
Last Update Date: 02/15/2024
Certification Date: 02/15/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1325 STRATFORD LN
CLOVIS NM
88101-4917
US
IV. Provider business mailing address
PO BOX 5144
CLOVIS NM
88102-5144
US
V. Phone/Fax
- Phone: 510-502-6676
- Fax: 575-763-2291
- Phone: 575-763-1715
- Fax: 575-763-2291
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YP1600X |
| Taxonomy | Pastoral Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QC1500X |
| Taxonomy | Community Health Clinic/Center |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QR0800X |
| Taxonomy | Recovery Care Clinic/Center |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 324500000X |
| Taxonomy | Substance Abuse Rehabilitation Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
GLORIA
S
YANCY
Title or Position: CEO
Credential: DR
Phone: 510-502-6676