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General NPI Number Information
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NPI Number | 1700483849
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Entity Type | Organization
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Legal Business Name | TRUENORTH STAR MINISTRIES
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Dates
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Enumeration Date | 10/01/2020
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Last Update Date | 10/01/2020
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Provider Practice Location Address
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Address Line | 2545 W HARVARD AVE
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City | ROSEBURG
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State | OR
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Zip | 97471-2582
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Country | US
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Telephone | 541-784-5071
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Fax | 541-637-5536
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Provider Business Mailing Address
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Address Line | PO BOX 1368
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City | ROSEBURG
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State | OR
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Zip | 97470-0334
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Country | US
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Telephone | 541-784-5071
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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 | CHRISTY GRAMMON
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Credential |
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Telephone | 541-784-5071
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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