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General NPI Number Information
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NPI Number | 1003530585
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Entity Type | Organization
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Legal Business Name | FRESNO NEW CREATION MINISTRIES INC.
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Dates
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Enumeration Date | 09/28/2022
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Last Update Date | 09/28/2022
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Provider Practice Location Address
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Address Line | 5150 N 6TH ST STE 132
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City | FRESNO
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State | CA
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Zip | 93710-7522
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Country | US
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Telephone | 559-227-1066
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5451
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City | FRESNO
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State | CA
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Zip | 93755-5451
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Country | US
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Telephone | 559-227-1066
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MICHAEL MANZIE
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Credential |
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Telephone | 559-770-9745
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number |
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License Number State |
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