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General NPI Number Information
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NPI Number | 1285116137
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Entity Type | Organization
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Legal Business Name | SAVE OUR SHIP MAROOMS LLC
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Dates
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Enumeration Date | 09/06/2018
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Last Update Date | 05/31/2023
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Provider Practice Location Address
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Address Line | 3595 GRAND ST
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City | BEAUMONT
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State | TX
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Zip | 77703-3517
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Country | US
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Telephone | 409-444-6377
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Fax |
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Provider Business Mailing Address
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Address Line | 3595 GRAND ST
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City | BEAUMONT
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State | TX
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Zip | 77703-3517
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Country | US
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Telephone | 409-833-6002
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Fax |
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Authorized Official
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Title or Position | BACHELOR SCIENCE NURSINH
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Name | RICHARD LAWRENCE (AGAPE) STANLEY
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Credential | BSN
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Telephone | 478-588-7617
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374K00000X
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Taxonomy Name | Religious Nonmedical Practitioner
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License Number |
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License Number State |
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