Healthcare Provider Details
I. General information
NPI: 1447474192
Provider Name (Legal Business Name): MORNING STAR FAMILY MINISTRIES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/12/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
103 EAST STATE ST.
MARTIN SD
57551-0845
US
IV. Provider business mailing address
103 EAST STATE ST. P O BOX 845
MARTIN SD
57551-0845
US
V. Phone/Fax
- Phone: 605-685-6710
- Fax: 605-685-6714
- Phone: 605-685-6710
- Fax: 605-685-6714
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
GAYLE
E
KOCER
Title or Position: ACTING DIRECTOR
Credential:
Phone: 605-685-6710