Healthcare Provider Details

I. General information

NPI: 1720450075
Provider Name (Legal Business Name): THE TRUTH OUTREACH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2015
Last Update Date: 11/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

185 CORNERSTONE DRIVE
WEST UNION SC
29696
US

IV. Provider business mailing address

185 CORNERSTONE DR
WEST UNION SC
29696-2623
US

V. Phone/Fax

Practice location:
  • Phone: 864-275-1463
  • Fax: 864-382-6545
Mailing address:
  • Phone: 864-275-1453
  • Fax: 864-382-6545

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateSC

VIII. Authorized Official

Name: MARIA R DAVIS
Title or Position: PASTOR
Credential: BACHELOR DEGREE
Phone: 864-275-1463