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General NPI Number Information
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NPI Number | 1366750309
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Entity Type | Organization
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Legal Business Name | GREAT HOPE MISSIONARY BAPTIST CHURCH
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Dates
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Enumeration Date | 09/23/2010
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Last Update Date | 09/23/2010
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Provider Practice Location Address
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Address Line | 119 FOX RD. SE
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City | CONOVER
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State | NC
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Zip | 28613
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Country | US
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Telephone | 828-466-0022
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Fax |
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Provider Business Mailing Address
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Address Line | 3683 DOROTHYS LN
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City | NEWTON
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State | NC
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Zip | 28658-8258
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | TONI WOODS
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Credential |
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Telephone | 828-428-0146
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training 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 | 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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