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General NPI Number Information
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NPI Number | 1598156002
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Entity Type | Organization
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Legal Business Name | CHRIST THE KING FAITH TEMPLE MINISTRIES
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Dates
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Enumeration Date | 02/05/2015
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Last Update Date | 02/05/2015
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Provider Practice Location Address
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Address Line | 3176 WEIR AVE
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City | WEIRTON
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State | WV
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Zip | 26062-4809
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Country | US
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Telephone | 304-224-1060
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Fax |
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Provider Business Mailing Address
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Address Line | 73 EAST ST.
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City | NEW CUMBERLAND
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State | WV
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Zip | 26047-1503
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Country | US
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Telephone | 740-275-6077
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Fax |
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Authorized Official
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Title or Position | CEO/FOUNDER
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Name | MRS. CHRISTINE WILLIAMS
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Credential | RN
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Telephone | 304-374-0734
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 1302076
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 269712
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License Number State | OH
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