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General NPI Number Information
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NPI Number | 1417596867
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Entity Type | Organization
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Legal Business Name | HEAVEN RACE MINISTRIES
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Dates
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Enumeration Date | 01/02/2020
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Last Update Date | 01/02/2020
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Provider Practice Location Address
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Address Line | 1032 EDMONDS AVE NE
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City | RENTON
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State | WA
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Zip | 98056-2920
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Country | US
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Telephone | 206-229-1836
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 598
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City | RENTON
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State | WA
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Zip | 98057-0598
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Country | US
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Telephone | 206-229-1836
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | ALEX SSEBUGWAWO
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Credential |
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Telephone | 206-286-0653
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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