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General NPI Number Information
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NPI Number | 1689344327
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Entity Type | Organization
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Legal Business Name | GODS PROPHETIC SERVANTS GPS
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Dates
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Enumeration Date | 09/15/2021
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Last Update Date | 09/12/2023
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Provider Practice Location Address
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Address Line | 8016 MADEIRA DR
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City | PASCO
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State | WA
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Zip | 99301-7919
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Country | US
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Telephone | 253-431-3598
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Fax |
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Provider Business Mailing Address
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Address Line | 8016 MADEIRA DR
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City | PASCO
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State | WA
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Zip | 99301-7919
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Country | US
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Telephone | 253-431-3598
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Fax |
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Authorized Official
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Title or Position | DIRECTOR;
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Name | ROBERT M KYLER
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Credential | BEHAVIORAL INTERVEN
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Telephone | 253-431-3598
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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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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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Taxonomy #3
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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