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General NPI Number Information
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NPI Number | 1073322509
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Entity Type | Organization
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Legal Business Name | GW INC SOCIAL JUSTICE MINISTRIES
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Dates
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Enumeration Date | 12/30/2024
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Last Update Date | 12/30/2024
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Provider Practice Location Address
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Address Line | 5959 E NORTHWEST HWY APT 1066
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City | DALLAS
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State | TX
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Zip | 75231-7439
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Country | US
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Telephone | 602-762-1030
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Fax |
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Provider Business Mailing Address
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Address Line | 5959 E NORTHWEST HWY APT 1066
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City | DALLAS
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State | TX
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Zip | 75231-7439
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Country | US
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Telephone | 602-762-1030
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MR. GARRICK DEWAYNE WARD
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Credential | NONE-PROFIT OWNER
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Telephone | 602-762-1030
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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