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General NPI Number Information
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NPI Number | 1114277753
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Entity Type | Organization
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Legal Business Name | NEW BIRTH IN CHRIST MINISRTY
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Dates
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Enumeration Date | 09/11/2012
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Last Update Date | 09/11/2012
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Provider Practice Location Address
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Address Line | 6932 WOFFORD AVE
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City | DALLAS
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State | TX
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Zip | 75227-5836
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Country | US
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Telephone | 972-966-9980
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Fax |
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Provider Business Mailing Address
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Address Line | 2914 LINFIELD RD
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City | DALLAS
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State | TX
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Zip | 75216-6621
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Country | US
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Telephone | 972-966-9980
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Fax |
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Authorized Official
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Title or Position | PASTOR
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Name | ETHEL S. GEORGE
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Credential | BISHOP
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Telephone | 972-966-9980
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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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 | 3104A0625X
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Taxonomy Name | Assisted Living Facility (Mental Illness)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 311Z00000X
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Taxonomy Name | Custodial Care Facility
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number |
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License Number State |
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