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General NPI Number Information
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NPI Number | 1225389521
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Entity Type | Organization
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Legal Business Name | SET THE CAPTIVES DELIVERANCE MINISTRY
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Dates
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Enumeration Date | 09/26/2012
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Last Update Date | 09/26/2012
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Provider Practice Location Address
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Address Line | 1039 W FLORENCE AVE
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City | LOS ANGELES
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State | CA
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Zip | 90044-2441
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Country | US
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Telephone | 310-908-3856
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Fax | 301-961-3658
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Provider Business Mailing Address
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Address Line | 1039 W FLORENCE AVE
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City | LOS ANGELES
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State | CA
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Zip | 90044-2441
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Country | US
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Telephone | 310-908-3856
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Fax | 301-961-3658
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Authorized Official
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Title or Position | PROGRAM DIRECTOR
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Name | MS. SHEILA CLAIBORNE
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Credential |
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Telephone | 310-908-3856
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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