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General NPI Number Information
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NPI Number | 1235782608
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Entity Type | Organization
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Legal Business Name | THE CONNECTION CHURCH CORPORATION
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Dates
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Enumeration Date | 07/24/2019
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Last Update Date | 07/24/2019
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Provider Practice Location Address
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Address Line | 4117 NEPTUNE RD
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City | SAINT CLOUD
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State | FL
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Zip | 34769-6741
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Country | US
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Telephone | 407-729-5847
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Fax |
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Provider Business Mailing Address
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Address Line | 700 GENERATION PT
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City | KISSIMMEE
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State | FL
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Zip | 34744-5957
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Country | US
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Telephone | 407-744-7007
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Fax |
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Authorized Official
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Title or Position | ASSOCIATE PASTOR
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Name | MR. THOMAS N TODD JR.
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Credential | MDIV MA
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Telephone | 407-729-5847
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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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