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General NPI Number Information
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NPI Number | 1124827860
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Entity Type | Organization
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Legal Business Name | CHRISTIAN GRACE MINISTRIES, INC.
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Dates
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Enumeration Date | 03/13/2025
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Last Update Date | 03/13/2025
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Provider Practice Location Address
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Address Line | 11875 PIGEON PASS RD # 1076
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City | MORENO VALLEY
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State | CA
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Zip | 92557-6039
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Country | US
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Telephone | 800-355-4615
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Fax |
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Provider Business Mailing Address
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Address Line | 11875 PIGEON PASS RD # 1076
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City | MORENO VALLEY
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State | CA
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Zip | 92557-6039
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Country | US
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Telephone | 800-355-4615
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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 | LAWRENCE FLOYD
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Credential |
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Telephone | 800-355-4615
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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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 | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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