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General NPI Number Information
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NPI Number | 1669802005
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Entity Type | Organization
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Legal Business Name | SERVINGLEADERS MINISTRIES
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Dates
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Enumeration Date | 11/21/2013
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Last Update Date | 05/03/2017
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Provider Practice Location Address
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Address Line | 1564 MCDANIEL DR
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City | WEST CHESTER
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State | PA
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Zip | 19380-6672
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Country | US
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Telephone | 610-517-0437
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Fax |
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Provider Business Mailing Address
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Address Line | 1564 MCDANIEL DR
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City | WEST CHESTER
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State | PA
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Zip | 19380-6672
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Country | US
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Telephone | 610-517-0437
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. DAVID WIEDIS
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Credential | J.D.
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Telephone | 610-517-0437
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | PC005435
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License Number State | PA
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