Healthcare Provider Details

I. General information

NPI: 1891174512
Provider Name (Legal Business Name): GOD'S AMAZING GRACE MINISTRIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2015
Last Update Date: 05/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 N. ST. PAUL STE 3100
DALLAS TX
75201
US

IV. Provider business mailing address

P.O. BOX 4783
DALLAS TX
75208
US

V. Phone/Fax

Practice location:
  • Phone: 469-513-4064
  • Fax: 469-513-4001
Mailing address:
  • Phone: 469-513-4064
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: MRS. LENA HUGHES
Title or Position: DIRECTOR
Credential:
Phone: 469-513-4064